Bridgewater Counseling

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2017035746 Issued in MO

Legal business name

BRIDGEWATER COUNSELING

Practice address

1949 Jackson St
Columbia, MO 65202-3134

Phone

(573) 567-0188

NPI assigned

Nov 6, 2017

Organization subpart

No

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

Authorized official

Name

Ellen Marie Moore, LCSW

Title

Therapist

Phone

(573) 673-0517

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1992218549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 JACKSON ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 JACKSON ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023134",
            "telephone_number": "573-567-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWATER COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "573-673-0517",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MO",
            "license": "2017035746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay T Bridgeman, M.D., D.D.S
• Pauline K Bridgeman, M.D.
• Amy Leigh Bridges, MD
• Jeffrey Almon Bridges, M.P.T., A.T.C.
• Bridget P. Early, MD, LLC
• Teresa Ann Briedwell, PT
• Stephen A Brietzke, MD
• Jessie K Brimer, MS, LPC
• Brinkley Isl
• Barbara Lynn Brinkman, CCC-SLP

• Community/Behavioral Health Agency in Columbia, MO
• Providers in Columbia, 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 Nov 6, 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.