Individual provider Active NPI

Carol Ann Bridgman

  • Clinical Social Worker
  • Wilmington, DE
National Provider Identifier
1609185784
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0000860 Issued in DE
Practice address
1303 Delaware Ave
Suite 103
Wilmington, DE 19806-3419
Phone
(610) 517-4535
NPI assigned
Oct 6, 2010
Last updated
Dec 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Q1-0000860 DE Primary
Clinical Social Worker 1041C0700X CW015143 PA

Addresses

Primary practice location

1303 Delaware Ave
Suite 103
Wilmington, DE 19806-3419

Mailing address

4 Harlech Dr
Wilmington, DE 19807-2508
Phone (610) 517-4535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0000860DEMDClinical Social Worker
CW015143PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1609185784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HARLECH DR",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198072508",
            "telephone_number": "610-517-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 DELAWARE AVE",
            "address_2": "SUITE 103",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198063419",
            "telephone_number": "610-517-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGMAN",
        "first_name": "CAROL ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-06",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000860",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.