Provider Demographics
NPI:1952014359
Name:BRIDGE & ASSOCIATES PLLC
Entity type:Organization
Organization Name:BRIDGE & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUMMINGS-BRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LMFT
Authorized Official - Phone:817-872-2663
Mailing Address - Street 1:11784 EAST CT
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-5532
Mailing Address - Country:US
Mailing Address - Phone:817-872-2663
Mailing Address - Fax:817-989-1329
Practice Address - Street 1:11784 EAST CT
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-5532
Practice Address - Country:US
Practice Address - Phone:817-872-2663
Practice Address - Fax:817-989-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX02651959OtherMEDICARE PTAN