Organization Active NPI

Julia S Tucker Wood

Doing business as Bridges on Elm

  • Community/Behavioral Health Agency
  • Old Saybrook, CT
National Provider Identifier
1972043818
Registry record updated Feb 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
001034 Issued in CT
Legal business name
JULIA S TUCKER WOOD
Doing business as
Bridges on Elm
Practice address
97 Elm St
Old Saybrook, CT 06475-4144
Phone
(860) 575-0811
Fax
(860) 339-5114
NPI assigned
Feb 26, 2017
Last updated
Feb 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2017

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

Authorized official

Name
Julia S Tucker Wood
Title
LMFT
Phone
(860) 575-0811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 001034 CT Primary

Addresses

Primary practice location

97 Elm St
Old Saybrook, CT 06475-4144

Mailing address

97 Elm St
Old Saybrook, CT 06475-4144
Phone (860) 575-0811

Other names 1

  • Bridges on Elm Doing business as

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1488067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488067200000",
    "number": "1972043818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754144",
            "telephone_number": "860-575-0811",
            "fax_number": "860-339-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754144",
            "telephone_number": "860-575-0811",
            "fax_number": "860-339-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA S TUCKER WOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-26",
        "last_updated": "2017-02-26",
        "status": "A",
        "authorized_official_last_name": "TUCKER WOOD",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "LMFT",
        "authorized_official_telephone_number": "860-575-0811"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "001034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridges on Elm",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2017; 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.