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Organization

BRIDGEWAY COUNSELING CENTER, LC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRANK E SHULL M.ED. (OWNER)
(208) 746-6776
Entity
Organization

Contact information

Practice address
1630 23RD AVE, SUITE 301B, LEWISTON, ID 83501-6350
(208) 746-6776
(208) 746-1938
Mailing address
317 15TH AVE, LEWISTON, ID 83501-2757
(208) 746-6776
(208) 746-1938

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
07/30/2006
Last updated
09/11/2025
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