Individual
PAMELA ANITA BRIDGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
650 HENDERSON DR, SUITE 430, CARTERSVILLE, GA 30120-3744
(770) 334-2493
(770) 334-2675
Mailing address
650 HENDERSON DR, SUITE 430, CARTERSVILLE, GA 30120-3744
(770) 334-2493
(770) 334-2675
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CSW004483
GA
1041C0700X
Clinical Social Worker
Primary
CSW004483
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW004483
MEDICARE PART B
GA
Enumeration date
08/24/2009
Last updated
07/29/2015
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