HEALING BRIDGE LLC (NPI# 1891266375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891266375 |
| Entity Type | Organization |
| Organization Name | HEALING BRIDGE LLC |
| Practice Address |
1358 E Kingsley St Ste E Springfield MO 65804-7245 |
| Mailing Address |
717 E Placer Mill Rd Nixa MO 65714-7100 |
| Practice Telephone | 4174140333 |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2018-12-10 |
| Authorized Official Name | STEPHANIE M WACASER (LLC OWNER/PROVDER) |
| Authorized Official Telephone | 4172971952 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
1358 E KINGSLEY ST STE E |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-7245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619200490 | Stephanie M Wacaser | Social Worker | 1358 E Kingsley St Ste E, Springfield, MO 65804 | 2009-09-11 |
| 1124665799 | Alisha Dawn Ross | Counselor | 1358 E Kingsley St Ste E, Springfield, MO 65804-7245 | 2019-12-03 |
| 1013471143 | Ian Thomas Douglas | Counselor | 1358 E Kingsley St Ste E, Springfield, MO 65804-7245 | 2019-01-23 |
| 1316458441 | Psych Associates LLC | Psychologist | 1358 E Kingsley St Ste E, Springfield, MO 65804 | 2017-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518500107 | Radame Antonio Jusino | Community/Behavioral Health | 6 Loretta St, Springfield, MA 01118-1045 | 2019-10-25 |
| 1639710577 | Southeast Wellness Works | Community/Behavioral Health | 189 E 9th Ave, Springfield, CO 81073-1601 | 2019-10-02 |
| 1083260798 | Rite Care Home Health Services, LLC | Community/Behavioral Health | 9420 Park Hunt Ct, Springfield, VA 22153-1351 | 2019-08-18 |
| 1972159770 | Dr. Wadeson, LLC | Community/Behavioral Health | 5133 S Campbell Ave Ste 204, Springfield, MO 65810-2437 | 2019-08-16 |
| 1407408081 | Treasure of Hope Florida Inc | Community/Behavioral Health | 44 Edgewood St, Springfield, MA 01109-3025 | 2019-07-12 |
| 1013577642 | Latino Counseling Center, Inc | Community/Behavioral Health | 125 Liberty St Ste 100, Springfield, MA 01103-1109 | 2019-06-17 |
| 1871157768 | Able Autism Care LLC | Community/Behavioral Health | 54 Bissell St, Springfield, MA 01119-1451 | 2019-04-25 |
| 1528535770 | Tenea Claudette Davis | Community/Behavioral Health | 122 Chestnut St, Springfield, MA 01103-1538 | 2018-10-25 |
| 1982195707 | Asra Mir | Community/Behavioral Health | 140 High St Ste 2, Springfield, MA 01105-1442 | 2018-05-29 |
| 1558895375 | Legacy Counseling LLC | Community/Behavioral Health | 6564 Loisdale Ct Ste 600, Springfield, VA 22150-1829 | 2017-04-18 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on HEALING BRIDGE LLC.
| 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.