Provider Demographics
NPI:1710597406
Name:BRIDGE OF CHANGES, LLC
Entity type:Organization
Organization Name:BRIDGE OF CHANGES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-885-3965
Mailing Address - Street 1:1985 MAIN ST STE 305
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1074
Mailing Address - Country:US
Mailing Address - Phone:413-885-3965
Mailing Address - Fax:413-301-6825
Practice Address - Street 1:1985 MAIN ST STE 305
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1074
Practice Address - Country:US
Practice Address - Phone:413-301-6625
Practice Address - Fax:413-301-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)