Kim Mary Bridgwood, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0744541 Issued in NY

Practice address

732 Smithtown Byp Ste A55
Smithtown, NY 11787-5020

Phone

(631) 320-1070

NPI assigned

Apr 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1962760918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CECILY LN",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253302",
            "telephone_number": "163-149-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 SMITHTOWN BYP STE A55",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875020",
            "telephone_number": "631-320-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGWOOD",
        "first_name": "KIM",
        "middle_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0744541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Brenner
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• Ilene A Brickley, LMSW
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• Bridges to Tomorrow, Speech Language Pathology, PLLC
• Gretchen Brinkmann, LMSW
• Andrea Marie Brodhuber, LMSW
• Allison Beth Brodsky, LCSW
• Laura Brofka, M.A.
• Brookhaven Opticians Inc.

• Clinical Social Worker in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.