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Bridgette Lori Threat

Social Worker

Behavioral Health & Social Service Providers

5 Mink Hollow Ct, Owings Mills, MD 21117-4868

PECOS Enrollment

This provider is enrolled in PECOS as BRIDGETTE THREAT.

Based on the most recent information from CMS, provider Bridgette Lori Threat is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1780012138
Provider Type
Individual
Full Name
Threat, Bridgette Lori
Title
Mrs.
Credential
LCSW-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/23/2013
Last Updated
8/10/2021

Contact Information

Practice Location

5 Mink Hollow Ct, Owings Mills, MD 21117-4868

(443) 621-8886

Unlisted Fax

Mailing Location

5 Mink Hollow Ct, Owings Mills, MD 21117-4868

(443) 621-8886

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 17801 Maryland
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License 17801 Maryland

Bridgette Lori Threat

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Code

Description

License

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Description

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