NPIMap

Organization Active NPI

Bridge to Wellness Centers, LLC

  • Professional Counselor
  • Vienna, VA
National Provider Identifier
1427608124
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BRIDGE TO WELLNESS CENTERS, LLC
Practice address
1934 Old Gallows Rd Ste 360
Vienna, VA 22182-4040
Phone
(703) 752-6181
NPI assigned
Sep 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Authorized official

Name
Gail Leslie Grandela, LPCNPI 1750692307
Title
Owner
Phone
(757) 748-7620

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1934 Old Gallows Rd Ste 360
Vienna, VA 22182-4040

Mailing address

1934 Old Gallows Rd Ste 360
Vienna, VA 22182-4040
Phone (703) 752-6181

Other names 1

  • Bridge to Wellness Centers, LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.therapynotes.com Direct

National Provider Directory

National Provider Directory

Locations

1934 Old Gallows Rd
Ste 360
Vienna, VA 22182
Phone (703) 752-6181

Practitioners & affiliated clinicians

Practitioners 3

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": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1427608124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 OLD GALLOWS RD STE 360",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221824040",
            "telephone_number": "703-752-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 OLD GALLOWS RD STE 360",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221824040",
            "telephone_number": "703-752-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE TO WELLNESS CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "GRANDELA",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-748-7620",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.therapynotes.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1934 Old Gallows Rd Ste 360",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221824040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bridge to Wellness Centers, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.