NPIMap

Organization Active NPI

Bridges Academy, LLC

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1083010342
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
10-7278 Issued in IL
Legal business name
BRIDGES ACADEMY, LLC
Practice address
5911 N Leader Ave
Chicago, IL 60646-5625
Phone
(773) 332-7382
Fax
(773) 305-0915
NPI assigned
Nov 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Authorized official

Name
Jayme L Crooks, MA, BCBA
Title
Executive Director
Phone
(773) 332-7382

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 10-7278 IL
Community/Behavioral Health Agency 251S00000X 10-7278 IL Primary

Addresses

Primary practice location

5911 N Leader Ave
Chicago, IL 60646-5625

Mailing address

5911 N Leader Ave
Chicago, IL 60646-5625
Phone (773) 332-7382

Other names 1

  • Indivisual Consulting, LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Bridges Academy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1083010342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 N LEADER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465625",
            "telephone_number": "773-332-7382",
            "fax_number": "773-305-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 N LEADER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465625",
            "telephone_number": "773-332-7382",
            "fax_number": "773-305-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES ACADEMY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "CROOKS",
        "authorized_official_first_name": "JAYME",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-332-7382",
        "authorized_official_credential": "MA, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "10-7278",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "10-7278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indivisual Consulting, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.