Provider Demographics
NPI:1861026163
Name:BRIDGING CONNECTIONS FAMILY COUNSELING INC
Entity Type:Organization
Organization Name:BRIDGING CONNECTIONS FAMILY COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:707-761-1153
Mailing Address - Street 1:172 SILVER EAGLE WAY
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-1012
Mailing Address - Country:US
Mailing Address - Phone:707-761-1153
Mailing Address - Fax:707-334-2155
Practice Address - Street 1:419 ELIZABETH ST STE 4
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4602
Practice Address - Country:US
Practice Address - Phone:707-761-1153
Practice Address - Fax:707-334-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8845242Medicaid