Southern Bridge Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHERN BRIDGE COUNSELING, LLC

Practice address

3100 Moody Rd
Ste. a
Bonaire, GA 31005

Phone

(478) 449-1475

Fax

(888) 813-6815

NPI assigned

Mar 18, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Neva Evans

Title

Co-Owner

Phone

(478) 283-8322

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Southern Bridge Counseling LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Bridge Counseling, LLC

  • Community/Behavioral Health Agency
  • Kathleen, GA
  • NPI 1326407453
  NPD tax ID

Practitioners 1

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

• Neva Danielle Knight Fox, LMFT

  • Marriage & Family Therapist
  • Warner Robins, GA
  • NPI 1780041822
  Medicare reassignment NPD

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1891156758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MOODY RD",
            "address_2": "STE. A",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "31005",
            "telephone_number": "478-449-1475",
            "fax_number": "888-813-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MOODY RD",
            "address_2": "STE. A",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "31005",
            "telephone_number": "478-449-1475",
            "fax_number": "888-813-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BRIDGE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "NEVA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "478-283-8322",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie D. Shorter, M.D.
• Gene Marie Shremshock
• Richard Thomas Skillen, PA-C
• Jessica Ann Smith, AGPCNP-BC
• Leeza Solomon
• Southern Hearts Homecare of Georgia Inc
• Southern Superior Solutions
• Speak Easy Speech & Language LLC
• Todd Michael Spees
• Tamia Stokes

• Community/Behavioral Health Agency in Bonaire, GA
• Providers in Bonaire, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.