Bainbridge House, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

37PC00526200 Issued in NJ

Legal business name

BAINBRIDGE HOUSE, LLC

Doing business as

Bainbridge House COunseling Services

Practice address

200 Passaic St
Hackensack, NJ 07601-3525

Phone

(551) 800-7101

NPI assigned

Sep 11, 2015

Last updated

Sep 11, 2015By 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

Ms. Mara Oliva, MA, LPC, LMHC

Title

Director

Phone

(201) 919-6184

Specialties & licenses 1

Addresses

Other names 1

• Bainbridge House COunseling Services Doing business as

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1306214960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PASSAIC ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013525",
            "telephone_number": "551-800-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PASSAIC ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013525",
            "telephone_number": "551-800-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAINBRIDGE HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "OLIVA",
        "authorized_official_first_name": "MARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-919-6184",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LPC, LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": "37PC00526200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bainbridge House COunseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Soumaya Bahlouli, MD, MS
• Yoo-Jin Michelle Baik, MD
• Paul D Bailey, M.D.
• Shadeen Bailey, RN
• Naomi Bailin, DPT
• Shannon Lee Bais, PT, DPT
• Bryan Karekin Bajakian, DC
• Alexia Baker, CNM
• Asma Baker, PTA
• Melissa Faith Baker, APN-BC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.