| Bridge To Peace Counseling, Llc | |
|
502 Wall St Ste 105 Valparaiso IN 46383-2599 | |
| (219) 627-1555 | |
| Not Available |
| Full Name | Bridge To Peace Counseling, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 502 Wall St Ste 105, Valparaiso, Indiana |
| Authorized Official Name and Position | Kym A Groceman (OWNER) |
| Authorized Official Contact | 2196271555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge To Peace Counseling, Llc 502 Wall St Ste 105 Valparaiso IN 46383-2599 Ph: (219) 627-1555 | Bridge To Peace Counseling, Llc 502 Wall St Ste 105 Valparaiso IN 46383-2599 Ph: (219) 627-1555 |
| NPI Number | 1205430261 |
|---|---|
| Provider Enumeration Date | 11/30/2020 |
| Last Update Date | 12/02/2020 |
| Certification Date | 12/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205430261 | NPI | - | NPPES |
| 39002848A | Other | IN | BEHAVIORAL HEALTH AND HUMAN SERVICES LICENSING BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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