Aja Bridgewater, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006864A Issued in IN

Practice address

8320 Madison Ave
Indianapolis, IN 46227-6066

Phone

(317) 882-5122

Fax

(317) 888-8642

NPI assigned

Jul 29, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Aja Boudreau Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: aja.bridgewater.p1@direct.adultandchild.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Adult and Child Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1154368512
  Medicare reassignment
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1457769986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGEWATER",
        "first_name": "AJA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006864A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AJA",
            "last_name": "BOUDREAU",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Landon Bridges, LAT, ATC
• Michael Bridges
• Shannon Bridges
• Troy Bridges, LCSW
• Veronica Bridges, MS,CSAYC
• Bryce Bridgewater, DO
• Jacqualine Bridgewater, NP
• Nedra Eleana Bridgewaters, RN
• Bridgeway LLC
• Evan Brien, BMBS

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.