Bridgeway INC

NPI #1588948046 in Normal, Illinois

Provider Information

NPI Number: 1588948046
Entity Type: Organization
Organization Name: Bridgeway INC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 3, 2011
Last Updated: Aug 19, 2019

Practice Location

Address: 310 WYLIE DR
Address 2: SUITE 464
City: Normal
State: Illinois
ZIP Code: 61761-5504
Phone: (309) 452-2797

Authorized Official

Name: WILLIAM NELSON
Title: CEO
Phone: (309) 344-2323

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X
Social Worker	104100000X
Community/Behavioral Health	251S00000X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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