Provider Demographics
NPI:1104659994
Name:BRIDGING PSYCHE PLLC
Entity type:Organization
Organization Name:BRIDGING PSYCHE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMARTO
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:412-303-7849
Mailing Address - Street 1:2025 WOODMONT BLVD APT 123
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-1563
Mailing Address - Country:US
Mailing Address - Phone:412-303-7849
Mailing Address - Fax:
Practice Address - Street 1:3200 W END AVE STE 500
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1322
Practice Address - Country:US
Practice Address - Phone:412-303-7849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)