Bridge the Gap, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BRIDGE THE GAP, INC

Practice address

1415 E Green Bay St
Suite 111
Shawano, WI 54166-3879

Phone

(715) 526-3791

Fax

(715) 526-5537

NPI assigned

May 5, 2015

Last updated

May 5, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lesley Linn Laluzerne

Title

President

Phone

(715) 526-3791

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lesley Kumm-Laluzerne

  • Behavior Analyst
  • Shawano, WI
  • NPI 1851766281
  NPD (past)
• Brittany Nicole Bartz

  • Behavior Analyst
  • Hickory, NC
  • NPI 1629434287
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1073990420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E GREEN BAY ST",
            "address_2": "SUITE 111",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663879",
            "telephone_number": "715-526-3791",
            "fax_number": "715-526-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E GREEN BAY ST",
            "address_2": "SUITE 111",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663879",
            "telephone_number": "715-526-3791",
            "fax_number": "715-526-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE THE GAP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "LALUZERNE",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "LINN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-526-3791"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Bowman
• Amy Elizabeth Bozzacco, LPC
• Rebecca A Brehm, BCBA
• Janean Carol Brewington
• Corinne Bricco
• Brosnan Chiropractic, LLC
• Michael E Brosnan, DC
• Heidi Marie Bruckert
• Kelly Marie Bueschel, M.S., LPC
• Tracy L Burke, RN

• Community/Behavioral Health Agency in Shawano, WI
• Providers in Shawano, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.