Healing Bridge LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HEALING BRIDGE LLC

Practice address

1358 E Kingsley St Ste E
Springfield, MO 65804-7245

Phone

(417) 414-0333

NPI assigned

Dec 10, 2018

Organization subpart

No

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

Authorized official

Name

Stephanie M Wacaser, LCSWNPI 1619200490

Title

LLC Owner/Provder

Phone

(417) 297-1952

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 6

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

• Stephanie M Wacaser, LCSW

  • Clinical Social Worker
  • Springfield, MO
  • NPI 1619200490
  Medicare reassignment NPD Authorized official
• Gabriel A Cline, PH.D.

  • Psychologist
  • Springfield, MO
  • NPI 1558555045
  NPD (past)
• Ian Thomas Douglas, PLPC

  • Professional Counselor
  • Springfield, MO
  • NPI 1013471143
  NPD (past)
• Michelle Eileen Houghton, LPC

  • Professional Counselor
  • Springfield, MO
  • NPI 1326884958
  NPD (past)
• Patrick D Patterson, PLPC

  • Mental Health Counselor
  • Springfield, MO
  • NPI 1629646195
  NPD (past)
• Alisha Dawn Ross, MS, PLPC

  • Professional Counselor
  • Springfield, MO
  • NPI 1124665799
  NPD (past)

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1891266375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 E PLACER MILL RD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 E KINGSLEY ST STE E",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047245",
            "telephone_number": "417-414-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING BRIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "WACASER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LLC OWNER/PROVDER",
        "authorized_official_telephone_number": "417-297-1952",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magda Hayton, MS, LPC
• Bailee Hayward
• Hcow- Healthcare on Wheels L.C.
• Heady & Pham Advanced Eyecare LLC
• Ryan Jeffrey Heady, O.D.
• Healing Hands Chiropractic & Massage, LLC
• Health Direct Plus
• Health Guardian Imaging LLC
• Health Hub LLC
• Healthback Home Health of S.W. Missouri, Inc.

• Community/Behavioral Health Agency in Springfield, MO
• Providers in Springfield, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.