Provider Demographics
NPI:1891572046
Name:BRIDGING WELLNESS LLC
Entity Type:Organization
Organization Name:BRIDGING WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:908-259-4664
Mailing Address - Street 1:2 NORTH RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-2369
Mailing Address - Country:US
Mailing Address - Phone:908-259-4664
Mailing Address - Fax:
Practice Address - Street 1:2 NORTH RD
Practice Address - Street 2:SUITE 3
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-2369
Practice Address - Country:US
Practice Address - Phone:908-259-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health