BRIDGEHAVEN, INC. (NPI# 1093823817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093823817 |
| Entity Type | Organization |
| Organization Name | BRIDGEHAVEN, INC. |
| Other Organization Name | BRIDGEHAVEN MENTAL HEALTH SERVICES |
| Practice Address |
950 S 1st St Louisville KY 40203-2288 |
| Practice Telephone | 5025859444 |
| Practice Fax Number | 5025859466 |
| Mailing Telephone | 5025859444 |
| Mailing Fax Number | 5025859466 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2016-03-10 |
| Authorized Official Name | MS. RAMONA L JOHNSON (PRESIDENT/CEO) |
| Authorized Official Telephone | 5025859444 |
| Authorized Official Credential | ARNP, CS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | 800159 | KY | Agencies |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MAGELLAN | 213150000 | 01 |
| KY | 30606099 | 05 | |
| KY | VALUE OPTIONS | 318961 | 01 |
| KY | 7100340960 | 05 |
| Other Name | Type Code |
|---|---|
| Bridgehaven Mental Health Services | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BRIDGEHAVEN, INC. | 950 S 1st St, Louisville, KY 40203-2202 |
| Street Address |
950 S 1ST ST |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40203-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780223867 | Beth M Willis | Counselor | 950 S 1st St, Louisville, KY 40203-2202 | 2020-01-06 |
| 1194298232 | Carrie Sommerville | Peer Specialist | 950 S 1st St, Louisville, KY 40203-2202 | 2019-01-10 |
| 1518452358 | Joseph William Etterer | Art Therapist | 950 S 1st St, Louisville, KY 40203-2202 | 2018-06-25 |
| 1992235576 | Edith H Johnson | Counselor | 950 S 1st St, Louisville, KY 40203-2202 | 2017-06-15 |
| 1285175380 | Susan Pope | Peer Specialist | 950 S 1st St, Louisville, KY 40203-2202 | 2017-03-09 |
| 1386097145 | Michael Brandon Banks | Peer Specialist | 950 S 1st St, Louisville, KY 40203-2202 | 2016-07-18 |
| 1841643608 | Benjamin J Jaggers | Peer Specialist | 950 S 1st St, Louisville, KY 40203-2202 | 2016-07-18 |
| 1801255351 | Anthony Ross | Peer Specialist | 950 S 1st St, Louisville, KY 40203-2202 | 2016-02-12 |
| 1548626658 | Jennifer Hall | Peer Specialist | 950 S 1st St, Louisville, KY 40203-2202 | 2016-01-05 |
| 1316323264 | Tara Bassett | Peer Specialist | 950 S 1st St, Louisville, KY 40203-2202 | 2015-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211738 | Integrated Health Systems LLC | Psychiatry & Neurology | 645 S Roy Wilkins Ave Ste 300, Louisville, KY 40203 | 2018-07-18 |
| 1104317734 | Usimc of West Virginia Medical Corporation | Clinic/Center | 908 W Broadway Fl 8, Louisville, KY 40203 | 2018-05-18 |
| 1699296293 | Jennifer Christine Angermeier | Nurse Practitioner | 1130 W Chestnut St, Louisville, KY 40203 | 2017-07-05 |
| 1083162812 | Deloris Jean Johnson | Social Worker | 1022 South 6th Street, Louisville, KY 40203 | 2016-09-21 |
| 1770978512 | Michael Bricken | Pediatrics | 760 S Hancock St # B100, Louisville, KY 40203 | 2015-03-30 |
| 1770906885 | Jason Scott Underhill | Counselor | 214 E Breckinridge St, Louisville, KY 40203 | 2014-01-24 |
| 1316372592 | Tonya Alicia Clay | Marriage & Family Therapist | 1000 South 5th Street, Family & Children's Place, Louisville, KY 40203 | 2013-09-06 |
| 1780929216 | Harambee Health Center, Inc | Clinic/Center | 800 South Preston St., Louisville, KY 40203 | 2012-12-10 |
| 1083977276 | Synergy Rehabilitation, Inc. | Physical Therapist | 832 S. 6th Street, Suite C, Louisville, KY 40203 | 2012-06-21 |
| 1043572803 | Sonya Helen Mitchell | Counselor | 2225 W. Broadway, Louisville, KY 40203 | 2012-06-07 |
| Find all providers in zip 40203 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1952883621 | New Hope Counseling | Clinic/Center | 1313 Lyndon Ln Ste 208, Louisville, KY 40222-7302 | 2018-08-30 |
| 1780854034 | Random House Community Living Inc | Clinic/Center | 5505 Random Way, Louisville, KY 40291-1821 | 2008-03-03 |
| 1902371859 | Avenues Unlimited Counseling Center | Clinic/Center | 3701 Taylorsville Rd Ste 2, Louisville, KY 40220-1351 | 2018-10-08 |
| 1659884872 | New Leaf Clinic | Clinic/Center | 2910 W Jefferson St, Louisville, KY 40212 | 2017-11-09 |
| 1265893598 | Dennis Buchholz Phd and Associates | Clinic/Center | 1161 E Broadway, Louisville, KY 40204-1711 | 2016-03-15 |
| 1609250992 | Brock Family Therapy Center Inc. | Clinic/Center | 10300 Brookridge Village Blvd, Suite 104, Louisville, KY 40291 | 2015-07-16 |
| 1578812707 | Donna A Head | Clinic/Center | 9880 Angies Way Ste 420, Louisville, KY 40241 | 2012-09-04 |
| 1386848836 | John E. Gallehr, Md P.s.c. | Clinic/Center | 8013 New Lagrange Rd, Suite # 1, Louisville, KY 40222-4700 | 2007-06-11 |
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| 1871126128 | T.m.j.j.w., LLC | Clinic/Center | 3192 Dixie Hwy, Erlanger, KY 41018-1850 | 2020-02-14 |
| 1679042279 | Safe Harbor Mental Health | Clinic/Center | 33 Jacks Ln, Somerset, KY 42501-6152 | 2018-11-13 |
| 1689077836 | Heidi Solarz-kutz, Lcsw, Cadc | Clinic/Center | 7204 Highway 329, Crestwood, KY 40014-8822 | 2014-10-02 |
| 1275975955 | Kara Stebbins, Md, Pllc | Clinic/Center | 832 Tremont Ave, Lexington, KY 40502-2234 | 2013-07-23 |
| 1962787572 | Sharad Patel LLC | Clinic/Center | 1230 Woodland Dr Ste 210, Elizabethtown, KY 42701-2792 | 2011-10-14 |
| 1073776514 | Whispering Winds Community Living, Inc. | Clinic/Center | 1600 Bridgeport Rd, Frankfort, KY 40601-8359 | 2008-07-04 |
| 1689852170 | Combs Residential Service, Inc. | Clinic/Center | 11455 North Highway 27, Eubank, KY 42567 | 2008-02-06 |
| 1952595381 | Dayspring Counseling Center | Clinic/Center | 2673 Campbellsville Rd, Greensburg, KY 42743-9703 | 2007-08-29 |
| 1457461659 | Jose Luis Garrido | Clinic/Center | 3400 New Hartford Rd, Suite A, Owensboro, KY 42303-1705 | 2006-08-30 |
| 1407879349 | Wendell Foster's Campus for Developmental Disabilities | Clinic/Center | 815 Triplett St, Owensboro, KY 42303-3564 | 2006-07-25 |
| Find all providers with the same taxonomy | ||||
| City | LOUISVILLE |
| Zip Code | 40203 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.