NPIMap

Organization Active NPI

Bridges Therapeutic Services PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1306350012
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BRIDGES THERAPEUTIC SERVICES PLLC
Practice address
10643 Kettering Dr Ste 109
Charlotte, NC 28226-4900
Phone
(704) 762-1361
NPI assigned
Nov 17, 2017
Last updated
Jun 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Marcus L Robinson, LCMHCNPI 1205175809
Title
Owner
Phone
(704) 762-1361

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8478 NC
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

10643 Kettering Dr Ste 109
Charlotte, NC 28226-4900

Mailing address

10643 Kettering Dr Ste 109
Charlotte, NC 28226-4900
Phone (704) 762-1361

Other practice location 1

10643 Kettering Dr. Suite 109
Charlotte, NC 28226
Phone (704) 762-1361

National Provider Directory

National Provider Directory

Locations

10643 Kettering Dr
Ste 109
Charlotte, NC 28226
Phone (704) 762-1361

5970 Fairview Rd
Ste 126
Charlotte, NC 28210
Phone (704) 412-8830

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1306350012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10643 KETTERING DR STE 109",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282264900",
            "telephone_number": "704-762-1361",
            "fax_number": "980-505-8947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10643 KETTERING DR STE 109",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282264900",
            "telephone_number": "704-762-1361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10643 Kettering Dr. Suite 109",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28226",
            "country_code": "US",
            "telephone_number": "704-762-1361",
            "fax_number": "980-505-8947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGES THERAPEUTIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-762-1361",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8478",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

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