Keven S Bridge, MSW
Individual provider Active NPI Clinical Social Worker · Southampton, NY
NPI 1386764488 · NPPES record last updated Aug 18, 2007
Key facts
- NPI
- 1386764488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- RO24115-1 (NY)
- Practice address
- 137 Hampton Rd
Southampton, NY 11968-4923 - Phone
- (631) 287-3114
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RO24115-1 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | RO24115-1 | NY | Yes |
Addresses
Primary practice location
137 Hampton Rd
Southampton, NY 11968-4923
Mailing address
137 Hampton Rd
Southampton, NY 11968-4923
Phone (631) 287-3114
Other providers in Southampton, NY
- Megan Jean Bock
- Premsai Bondalapati
- James Brady
- Christine Brennan
- Gary Neal Brenner
- Kimberly Britt
- Olivier Bros
- Chenoa D Brown
- Agnieszka Brynda
- Emily Christine Bunce
All providers in Southampton, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.