Provider Demographics
NPI:1386767028
Name:BRIDGE CENTER FOR HEALING
Entity type:Organization
Organization Name:BRIDGE CENTER FOR HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-284-0238
Mailing Address - Street 1:300 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2253
Mailing Address - Country:US
Mailing Address - Phone:203-284-0238
Mailing Address - Fax:203-284-0238
Practice Address - Street 1:300 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2253
Practice Address - Country:US
Practice Address - Phone:203-284-0238
Practice Address - Fax:203-284-0238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT0010021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty