Provider Demographics
NPI:1720292253
Name:BRIDGE & ASSOCIATES
Entity type:Organization
Organization Name:BRIDGE & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUMMINGS-BRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-LCDC-LMFT
Authorized Official - Phone:817-872-2663
Mailing Address - Street 1:6914 CAMP BOWIE BLVD
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7117
Mailing Address - Country:US
Mailing Address - Phone:817-872-2663
Mailing Address - Fax:817-989-1329
Practice Address - Street 1:6914 CAMP BOWIE BLVD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7117
Practice Address - Country:US
Practice Address - Phone:817-872-2663
Practice Address - Fax:817-989-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11656101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty