Provider Demographics
NPI:1710570783
Name:BRIDGES TO WELLBEING LLC
Entity Type:Organization
Organization Name:BRIDGES TO WELLBEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:707-623-6911
Mailing Address - Street 1:1656 ROSS LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3429
Mailing Address - Country:US
Mailing Address - Phone:707-623-6911
Mailing Address - Fax:
Practice Address - Street 1:1656 ROSS LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3429
Practice Address - Country:US
Practice Address - Phone:707-623-6911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500698173Medicaid