Provider Demographics
NPI:1477311421
Name:BRIDGES II, RICKY
Entity Type:Individual
Prefix:MR
First Name:RICKY
Middle Name:
Last Name:BRIDGES II
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 MARYLAND AVE NE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3129
Mailing Address - Country:US
Mailing Address - Phone:202-286-5901
Mailing Address - Fax:
Practice Address - Street 1:1436 U ST NW STE 401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3988
Practice Address - Country:US
Practice Address - Phone:202-506-5496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health