Provider Demographics
NPI:1326466541
Name:ACROSS THE BRIDGE
Entity Type:Organization
Organization Name:ACROSS THE BRIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YUKO
Authorized Official - Middle Name:TANAKA
Authorized Official - Last Name:INZANA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-917-4011
Mailing Address - Street 1:114 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-1911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 ROSZEL RD
Practice Address - Street 2:SUITE A 103
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6234
Practice Address - Country:US
Practice Address - Phone:609-917-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05369800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3912200000OtherMAGELLAN