Bridging the Gap Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

906023 Issued in MD

Legal business name

BRIDGING THE GAP SERVICES, LLC

Practice address

3649 Leonardtown Rd
Waldorf, MD 20601-3626

Phone

(240) 318-5790

Fax

(240) 436-1349

NPI assigned

Jul 12, 2016

Organization subpart

No

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

Authorized official

Name

Karen Kemp, MHS, CSC-AD

Title

Executive Director

Phone

(240) 318-5790

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663372800000",
    "number": "1225480494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 WINDSOR DR",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207484052",
            "telephone_number": "240-318-5790",
            "fax_number": "240-436-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3649 LEONARDTOWN RD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013626",
            "telephone_number": "240-318-5790",
            "fax_number": "240-436-1349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5506 Windsor Dr",
            "address_purpose": "LOCATION",
            "city": "Temple Hills",
            "state": "MD",
            "postal_code": "207484052",
            "country_code": "US",
            "telephone_number": "240-318-5790",
            "fax_number": "240-436-1949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGING THE GAP SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2022-09-17",
        "certification_date": "2022-09-17",
        "status": "A",
        "authorized_official_last_name": "KEMP",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "240-318-5790",
        "authorized_official_credential": "MHS, CSC-AD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "906023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423396400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2022; 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.