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Individual

MICHAEL BRIDGES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCAS

Contact information

Practice address
116-118 NEW STATESIDE DR, CHAPEL HILL, NC 27516-1165
(919) 942-2803
Mailing address
104 NEW STATESIDE DR, CHAPEL HILL, NC 27516-1165
(919) 942-2803
(919) 942-2126

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
989
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6111896
NC
Enumeration date
05/29/2007
Last updated
08/05/2013
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