Provider Demographics
NPI:1912699596
Name:BRIDGE INTERFAITH SERVICES
Entity Type:Organization
Organization Name:BRIDGE INTERFAITH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:MCGARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:609-840-6034
Mailing Address - Street 1:507 ROUTE 9 SOUTH
Mailing Address - Street 2:
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223
Mailing Address - Country:US
Mailing Address - Phone:609-840-6034
Mailing Address - Fax:609-840-6313
Practice Address - Street 1:507 ROUTE 9 SOUTH
Practice Address - Street 2:
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223
Practice Address - Country:US
Practice Address - Phone:609-840-6034
Practice Address - Fax:609-840-6313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty