Bridging the Gap With Life Skills

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL092571 Issued in NC

Legal business name

BRIDGING THE GAP WITH LIFE SKILLS

Practice address

2507 Blackwolf Run LN
Raleigh, NC 27604-5425

Phone

(919) 250-9546

Fax

(919) 250-7569

NPI assigned

Feb 9, 2007

Organization subpart

Yes

Parent organization

LIFE SKILLS COUNSELING, PLLCAs reported in NPPES

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

Authorized official

Name

Miss Tammy Worthington

Title

Quality Servies Director

Phone

(919) 833-2544

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Life Skills Counseling PLLC

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1659412997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N PERSON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011047",
            "telephone_number": "919-833-2544",
            "fax_number": "919-833-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 BLACKWOLF RUN LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276045425",
            "telephone_number": "919-250-9546",
            "fax_number": "919-250-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGING THE GAP WITH LIFE SKILLS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFE SKILLS COUNSELING, PLLC",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "WORTHINGTON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "QUALITY SERVIES DIRECTOR",
        "authorized_official_telephone_number": "919-833-2544",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL092571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604129",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Lee Bridges
• Lori Clemons Bridges, PA-C
• Bridget a Neuman-Schiszler DDS, PA
• Bridgeway Counseling Services
• Bridging the Gap Developmental Services
• Brier Creek Family Practice, PLLC
• Brier Creek Imaging, LLC
• Brier Creek Integrated Pain & Spine PLLC
• Brier Creek Urgent Care
• Brier Creek Vision Care, PA

• All providers in Raleigh, NC
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.