NPIMap

Organization Active NPI

Bridges Behavioral Health & Wellness

  • Community/Behavioral Health Agency
  • Centreville, MD
National Provider Identifier
1205193737
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BRIDGES BEHAVIORAL HEALTH & WELLNESS
Practice address
207 N Liberty St
Suite B
Centreville, MD 21617-1022
Phone
(410) 758-8750
Fax
(410) 758-8751
NPI assigned
Apr 23, 2012
Last updated
Sep 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Mrs. Deborah Lynn Dadds, LGSWNPI 1669605101
Title
Executive Director
Phone
(410) 708-7626

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
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

207 N Liberty St
Suite B
Centreville, MD 21617-1022

Mailing address

207 N Liberty St
Suite B
Centreville, MD 21617-1022
Phone (410) 758-8750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120927000011 MD Part B Supplier - Clinic/Group Practice 0446409957 Receives reassigned benefits from 14 practitioners
Practice locations: Centreville, MD

National Provider Directory

National Provider Directory

Locations

207 N Liberty St
Ste B
Centreville, MD 21617
Phone (410) 758-8750

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1205193737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N LIBERTY ST",
            "address_2": "SUITE B",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171022",
            "telephone_number": "410-758-8750",
            "fax_number": "410-758-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N LIBERTY ST",
            "address_2": "SUITE B",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171022",
            "telephone_number": "410-758-8750",
            "fax_number": "410-758-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES BEHAVIORAL HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "DADDS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-708-7626",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LGSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.