Individual provider Active NPI

Angelique Bridges

  • Mental Health Counselor
  • Prince Frederick, MD
National Provider Identifier
1376140681
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC11972 Issued in MD
Practice address
35 Duke St Unit 106
Prince Frederick, MD 20678-7505
Phone
(443) 295-8955
NPI assigned
Oct 8, 2020
Last updated
Apr 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 174757 KY
Marriage & Family Therapist 106H00000X LCM846 MD
Mental Health Counselor 101YM0800X LC11972 MD Primary

Addresses

Primary practice location

35 Duke St Unit 106
Prince Frederick, MD 20678-7505

Mailing address

65 Duke St Ste 106
Prince Frederick, MD 20678-6128
Phone (270) 681-7876

Other practice location 1

110 Village Dr
Elizabethtown, KY 42701-2423
Phone (270) 763-0728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC11972MDMDMental Health Counselor
174757KYMDProfessional Counselor
LCM846MDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Cafe LLC Mental Health CurrentSince Apr 6, 2025 Accepting new patients

Locations

65 Duke St
Ste 106
Prince Frederick, MD 20678
Phone (443) 295-8955

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1376140681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 DUKE ST STE 106",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206786128",
            "telephone_number": "270-681-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 DUKE ST UNIT 106",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206787505",
            "telephone_number": "443-295-8955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427012423",
            "country_code": "US",
            "telephone_number": "270-763-0728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "ANGELIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "174757",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM846",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC11972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2025; 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.