NPIMap

Organization Active NPI

Bridge of Light LLC

  • Counseling Psychologist
  • Oklahoma City, OK
National Provider Identifier
1285453969
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
BRIDGE OF LIGHT LLC
Practice address
4512 Sunnyview Dr Apt 178
Oklahoma City, OK 73135-3163
Phone
(443) 991-1582
NPI assigned
Oct 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Xander Faison, LCPC
Title
Owner
Phone
(443) 991-1582

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

4512 Sunnyview Dr Apt 178
Oklahoma City, OK 73135-3163

Mailing address

4512 Sunnyview Dr Apt 178
Oklahoma City, OK 73135-3163
Phone (443) 991-1582

Other names 1

  • Breaking Barriers Together Health Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Breaking Barriers Together Health Group2 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.

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1285453969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 SUNNYVIEW DR APT 178",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731353163",
            "telephone_number": "443-991-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 SUNNYVIEW DR APT 178",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731353163",
            "telephone_number": "443-991-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE OF LIGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "FAISON",
        "authorized_official_first_name": "XANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-991-1582",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breaking Barriers Together Health Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.