NPIMap

Organization Active NPI

Bridges 2 Psychological Services LLC

  • Psychologist
  • Washington, DC
National Provider Identifier
1083075709
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY1000835 Issued in DC
Legal business name
BRIDGES 2 PSYCHOLOGICAL SERVICES LLC
Practice address
639 Atlantic St SE
Washington, DC 20032-3738
Phone
(202) 849-2915
Fax
(202) 627-5028
NPI assigned
Mar 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Authorized official

Name
Dr. Angelina Dickerson, PSY.D.NPI 1699958496
Title
Clinical Director/Psychologist
Phone
(202) 849-2915

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY1000835 DC Primary

Addresses

Primary practice location

639 Atlantic St SE
Washington, DC 20032-3738

Mailing address

639 Atlantic St SE
Washington, DC 20032-3738
Phone (202) 849-2915

Other names 1

  • Bridges 2 Psychological Services, LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Bridges 2 Psychological Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1083075709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 ATLANTIC ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200323738",
            "telephone_number": "202-849-2915",
            "fax_number": "202-627-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 ATLANTIC ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200323738",
            "telephone_number": "202-849-2915",
            "fax_number": "202-627-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES 2 PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "ANGELINA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/PSYCHOLOGIST",
        "authorized_official_telephone_number": "202-849-2915",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1000835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridges 2 Psychological Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Bridges 2 Psychological Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.