The Bridge Youth & Family Counseling Services, Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE BRIDGE YOUTH & FAMILY COUNSELING SERVICES, INC

Practice address

5384 Savannah Pkwy
Southaven, MS 38672-7515

Phone

(870) 270-8796

NPI assigned

Jan 19, 2018

Last updated

Jan 19, 2018By 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

Calvin Cosen

Title

Owner

Phone

(870) 270-8796

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1083122428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2182",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712201",
            "telephone_number": "713-582-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5384 SAVANNAH PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727515",
            "telephone_number": "870-270-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRIDGE YOUTH & FAMILY COUNSELING SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "COSEN",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-270-8796"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Southaven, MS
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.