Provider Demographics
NPI:1669714903
Name:BRIDGES THERAPY AND WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:BRIDGES THERAPY AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-865-4900
Mailing Address - Street 1:10560 ARROWHEAD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7322
Mailing Address - Country:US
Mailing Address - Phone:703-865-4900
Mailing Address - Fax:703-865-4922
Practice Address - Street 1:10560 ARROWHEAD DR STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7322
Practice Address - Country:US
Practice Address - Phone:703-865-4900
Practice Address - Fax:703-865-4922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003836103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty