Organization
BRIDGEWAY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSSA BROOKE MANCUSO LPC (OWNER)
(256) 466-9099
Entity
Organization
Contact information
Practice address
540 HUGHES RD STE 3, MADISON, AL 35758-8959
(256) 466-9099
Mailing address
540 HUGHES RD STE 3, MADISON, AL 35758-8959
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3534
AL
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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