NPIMap

Organization Active NPI

The Bridges Wellness Group, LLC.

  • Professional Counselor
  • Hyattsville, MD
National Provider Identifier
1396279824
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
THE BRIDGES WELLNESS GROUP, LLC.
Practice address
7050 Chesapeake Rd Ste 104
Hyattsville, MD 20784
Phone
(407) 707-2042
Fax
(866) 473-0669
NPI assigned
Apr 11, 2017
Last updated
May 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Dr. Marvin Nickleson Battle Jr., LCPC, LPCNPI 1598285488
Title
Chief Operating Officer
Phone
(703) 225-9118

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Professional Counselor 101YP2500X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

7050 Chesapeake Rd Ste 104
Hyattsville, MD 20784

Mailing address

7050 Chesapeake Rd Ste 104
Hyattsville, MD 20784-2345
Phone (240) 770-7204

Other identifiers 2

IdentifierTypeStateIssuer
024397355MedicaidDC
821004700MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A

National Provider Directory

National Provider Directory

Locations

7050 Chesapeake Rd
Ste 104
Landover Hills, MD 20784
Phone (240) 770-7204

Practitioners & affiliated clinicians

Practitioners 7

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": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1396279824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 CHESAPEAKE RD STE 104",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207842345",
            "telephone_number": "240-770-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 CHESAPEAKE RD STE 104",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "20784",
            "telephone_number": "407-707-2042",
            "fax_number": "866-473-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRIDGES WELLNESS GROUP, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "BATTLE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "NICKLESON",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "703-225-9118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCPC, LPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024397355",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "821004700",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "address_1": "7050 Chesapeake Rd Ste 104",
            "city": "Hyattsville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.