NPIMap

Organization Active NPI

A Bridge 2 Healing Therapeutic Services

  • Mental Health Counselor
  • Homewood, IL
National Provider Identifier
1801508528
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
A BRIDGE 2 HEALING THERAPEUTIC SERVICES
Practice address
930 175TH St
Homewood, IL 60430-2039
Phone
(708) 831-3943
Fax
(708) 794-0521
NPI assigned
Dec 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Authorized official

Name
Miss Enchelle R Morris, LCPCNPI 1750977872
Title
Owner/Clinical Therapist
Phone
(708) 831-3943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

930 175TH St
Homewood, IL 60430-2039

Mailing address

12254 S Yale Ave
Chicago, IL 60628-6529
Phone (708) 831-3943

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1801508528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 S YALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606286529",
            "telephone_number": "708-831-3943",
            "fax_number": "708-794-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 175TH ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302039",
            "telephone_number": "708-831-3943",
            "fax_number": "708-794-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BRIDGE 2 HEALING THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-14",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "ENCHELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "708-831-3943",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.