Provider Demographics
NPI:1144434226
Name:BRIDGES COUNSELING AND PSYCHOTHERAPY GROUP
Entity type:Organization
Organization Name:BRIDGES COUNSELING AND PSYCHOTHERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-847-4600
Mailing Address - Street 1:1081 MAIN STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524
Mailing Address - Country:US
Mailing Address - Phone:845-897-4600
Mailing Address - Fax:845-897-4604
Practice Address - Street 1:1081 MAIN STREET
Practice Address - Street 2:SUITE F
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524
Practice Address - Country:US
Practice Address - Phone:845-897-4600
Practice Address - Fax:845-897-4604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN2W371Medicare ID - Type Unspecified