NPIMap

Organization Active NPI

Bridges Habilitation Services, Inc.

Doing business as Bridges

  • Professional Counselor
  • Gillette, WY
National Provider Identifier
1447673678
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-1336 Issued in WY
Legal business name
BRIDGES HABILITATION SERVICES, INC.
Doing business as
Bridges
Practice address
400 S Kendrick Ave
Suite 101
Gillette, WY 82716-3848
Phone
(307) 682-1261
NPI assigned
Jan 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Authorized official

Name
Mr. David M CanenNPI 1861729667
Title
Ceo
Phone
(307) 789-0664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LPC-1336 WY Primary

Addresses

Primary practice location

400 S Kendrick Ave
Suite 101
Gillette, WY 82716-3848

Mailing address

PO Box 1642
Evanston, WY 82931-1642
Phone (307) 789-0664

Other identifiers 1

IdentifierTypeStateIssuer
1245305804MedicaidWY

Other names 1

  • Bridges Doing business as

National Provider Directory

National Provider Directory

Locations

1912 Capitol Ave
Ste 319
Cheyenne, WY 82001
Phone (307) 635-7100

400 S Kendrick Ave
Ste 101
Gillette, WY 82716
Phone (307) 682-1261

Practitioners & affiliated clinicians

Practitioners 1

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": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1447673678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1642",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829311642",
            "telephone_number": "307-789-0664",
            "fax_number": "307-789-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S KENDRICK AVE",
            "address_2": "SUITE 101",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163848",
            "telephone_number": "307-682-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES HABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "CANEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-789-0664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-1336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245305804",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridges",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.