NPIMap

Organization Active NPI

Southern Bridge Counseling, LLC

  • Case Management Agency
  • Kathleen, GA
National Provider Identifier
1326407453
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SOUTHERN BRIDGE COUNSELING, LLC
Practice address
100 Shoshone Circle
Kathleen, GA 31047
Phone
(910) 689-5190
NPI assigned
Feb 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Authorized official

Name
Darla Jackson
Title
Co Owner
Phone
(910) 689-5190

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

100 Shoshone Circle
Kathleen, GA 31047

Mailing address

100 Shoshone Circle
Kathleen, GA 31047
Phone (910) 689-5190

National Provider Directory

National Provider Directory
Tax ID family
Southern Bridge Counseling LLC2 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1326407453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHOSHONE CIRCLE",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "31047",
            "telephone_number": "910-689-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SHOSHONE CIRCLE",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "31047",
            "telephone_number": "910-689-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BRIDGE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "910-689-5190"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kathleen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.