Provider Demographics
NPI:1689791246
Name:BRIDGETTE A. SIMMONS LCSW PC
Entity Type:Organization
Organization Name:BRIDGETTE A. SIMMONS LCSW PC
Other - Org Name:CROSS THE BRIDGE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-590-3230
Mailing Address - Street 1:41 DOLSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940
Mailing Address - Country:US
Mailing Address - Phone:845-590-3230
Mailing Address - Fax:845-231-6078
Practice Address - Street 1:41 DOLSON AVENUE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-590-3230
Practice Address - Fax:845-231-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7479689Medicare UPIN
NY561845Medicare UPIN