Organization Active NPI

Bridge to Resolution Counseling and Rehabilitation

  • Community/Behavioral Health Agency
  • Jacksonville, FL
National Provider Identifier
1144793118
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BRIDGE TO RESOLUTION COUNSELING AND REHABILITATION
Practice address
5991 Chester Ave Ste 211
Jacksonville, FL 32217-2245
Phone
(904) 566-0200
NPI assigned
Jan 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Authorized official

Name
Tiffany S Wells, LMHCI
Title
Ceo
Phone
(904) 566-0200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5991 Chester Ave Ste 211
Jacksonville, FL 32217-2245

Mailing address

1164 E 17TH St
Jacksonville, FL 32206-3215
Phone (904) 566-0200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1144793118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 E 17TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063215",
            "telephone_number": "904-566-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5991 CHESTER AVE STE 211",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172245",
            "telephone_number": "904-566-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE TO RESOLUTION COUNSELING AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-566-0200",
        "authorized_official_credential": "LMHCI"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.