Bridge of Light

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BRIDGE OF LIGHT

Practice address

14300 N Pennsylvania Ave Apt 326
Oklahoma City, OK 73134-6063

Phone

(405) 568-1338

NPI assigned

Feb 5, 2022

Last updated

May 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Xander Daniel FaisonNPI 1255959508

Title

Owner

Phone

(405) 568-1338

Specialties & licenses 5

Addresses

Other names 1

• Bridge of Light LLC Other name

Electronic endpoints 1

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.

• Xander Faison, CMII,LPC

  • Clinical Child & Adolescent Psychologist
  • Oklahoma City, OK
  • NPI 1255959508

  Multi-Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1644019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1447904842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 N PENNSYLVANIA AVE APT 326",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346063",
            "telephone_number": "405-568-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 N PENNSYLVANIA AVE APT 326",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346063",
            "telephone_number": "405-568-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE OF LIGHT",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-05",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "FAISON",
        "authorized_official_first_name": "XANDER",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-568-1338",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "breakingbarrierstogether1@outlook.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "all",
            "address_1": "14300 N Pennsylvania Ave Apt 326",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731346063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bridge of Light LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Bridge of Light LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Bridge Builder Counseling & Consulting, LLC
• Bridge of Light LLC (Bridge of Light Inc)
• Bridge of Light LLC (Breaking Barriers Together Health Group)
• Jeremey Bridges
• Karli Bridges, COTA
• Kira Bridges

• Mental Health Counselor in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.