THE BRIDGE YOUTH & FAMILY COUNSELING SERVICES, INC (NPI# 1083122428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083122428 |
| Entity Type | Organization |
| Organization Name | THE BRIDGE YOUTH & FAMILY COUNSELING SERVICES, INC |
| Practice Address |
5384 Savannah Pkwy Southaven MS 38672-7515 |
| Mailing Address |
Po Box 2182 Southaven MS 38671-2201 |
| Practice Telephone | 8702708796 |
| Mailing Telephone | 7135822836 |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-19 |
| Authorized Official Name | CALVIN COSEN (OWNER) |
| Authorized Official Telephone | 8702708796 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
5384 SAVANNAH PKWY |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38672-7515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100826 | Sarah Kathryn Pratt | Physical Therapist | 5271 Getwell Road, Suite A, Southaven, MS 38672 | 2020-09-24 |
| 1356713606 | Deadra Dennis | Behavioral Analyst | 2816 Calico Rock Cv, Southaven, MS 38672 | 2015-10-27 |
| 1568727352 | Patricia Leanne Lewis | Family Medicine | 5908 Getwell Rd, Southaven, MS 38672 | 2012-07-09 |
| 1417183922 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2945 Goodman Road East, Southaven, MS 38672 | 2009-06-10 |
| 1568609998 | Susan Orsland | Physical Therapist | 4355 Genevieve Drive, Southaven, MS 38672 | 2009-01-07 |
| 1659516524 | Stacy L Sanders | Audiologist | 5740 Getwell Rd. Building 3 Unit B, Southaven, MS 38672 | 2008-12-08 |
| 1295927226 | Tracey F Petrides | Family Medicine | 5779 Getwell Road, Building D, Suite 3, Southaven, MS 38672 | 2007-08-14 |
| 1538288741 | Bruce A Denney | Dentist | 7125 Getwell Road, Suite 102, Southaven, MS 38672 | 2007-03-28 |
| 1154480150 | Kimberly Marie Metcalf | Social Worker | 7165-g Getwell Rd., Southaven, MS 38672 | 2006-12-06 |
| 1346318441 | Deborah Verucchi | Nurse Practitioner | 5740 Getwell Rd Ste B, Southaven, MS 38672 | 2006-11-30 |
| Find all providers in zip 38672 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310694 | Luke Garner | Counselor | 7467 Swinnea Rd, Southaven, MS 38671-6009 | 2020-06-08 |
| 1437634623 | Olivia Hall | Counselor | 5935 Airways Blvd Apt 1203, Southaven, MS 38671-1878 | 2018-10-03 |
| 1750754578 | Patricia M Wright Phd &associates, LLC | Counselor | 6928 Cobblestone Blvd, Suite 202, Southaven, MS 38672-8300 | 2015-11-02 |
| 1548699689 | Marilyn M Kerr, Lpc, LLC | Counselor | 230 Goodman Rd E Ste 3-204, Southaven, MS 38671-5152 | 2013-11-08 |
| 1629321815 | Jaqueline Tolleson Carter | Counselor | 6858 Swinnea Rd, 4 Rutland Pl, Southaven, MS 38671-9493 | 2012-10-25 |
| 1992086151 | Sandra Dietle | Counselor | 8830 Centre St Ste 5, Southaven, MS 38671-2609 | 2011-09-01 |
| 1215253620 | Anthony Jerome Wood | Counselor | 885 Ferncliff Cv, Suite 2, Southaven, MS 38671-2433 | 2010-04-09 |
| 1245420520 | Kelly Holloman Gardner | Counselor | 7165 Getwell Rd Bldg G, Southaven, MS 38672-9619 | 2007-08-01 |
| 1326678509 | Crystal Carter | Counselor | 6880 Cobblestone Blvd Ste 1, Southaven, MS 38672-9313 | 2020-01-16 |
| 1538648027 | Taji J Valentine | Counselor | 7160 Tchulahoma Rd Bldg B, Southaven, MS 38671-9266 | 2018-08-07 |
| Find all providers in SOUTHAVEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.