THE BRIDGE AUTISM CLINIC LLC (NPI# 1568017374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568017374 |
| Entity Type | Organization |
| Organization Name | THE BRIDGE AUTISM CLINIC LLC |
| Practice Address |
690 Cleveland Ave South Suite 100 St Paul MN 55116 |
| Mailing Address |
690 Cleveland Ave S # 100 Saint Paul MN 55116-1319 |
| Practice Telephone | 6122164647 |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | MELISSA HAMILTON (DIRECTOR CEO) |
| Authorized Official Telephone | 6514938412 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE BRIDGE AUTISM CLINIC LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
690 CLEVELAND AVE SOUTH SUITE 100 |
| City | ST PAUL |
| State | MN |
| Zip Code | 55116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306875 | Center for Validation and Change, L.L.C. | Social Worker | 790 Cleveland Avenue S. Ste; 211 790, St. Paul, MN 55116 | 2018-11-27 |
| 1114391307 | Therese Ann Wengler | Rehabilitation Hospital | 1206 Niles Avenue, Saint Paul, MN 55116 | 2015-11-25 |
| 1306220579 | Lauren Ann Wier | Social Worker | 577 Wawick St, Saint Paul, MN 55116 | 2015-07-16 |
| 1982097325 | Norah Hoverson | Dentist | 670 Cleveland Ave S Ste 100, Saint Paul, MN 55116 | 2015-03-10 |
| 1316336803 | Ryan W. Nolte | Chiropractor | 1150 Montreal Ave Ste 101, Saint Paul, MN 55116 | 2015-01-21 |
| 1316348642 | Highland Gw, LLC | Assisted Living Facility | 1925 Graham Avenue, St. Paul, MN 55116 | 2014-09-05 |
| 1972941185 | Creations Midwifery, LLC | Advanced Practice Midwife | 1235 Saint Paul Avenue, Saint Paul, MN 55116 | 2013-06-10 |
| 1992075428 | Nels Health Care, LLC | Licensed Practical Nurse | 2285 Stewart Ave, Suite 1107, St Paul, MN 55116 | 2011-12-30 |
| 1962717728 | Lindsey Hammond Teigland | Psychologist | 690 Cleveland Avenue South, St. Paul, MN 55116 | 2010-08-17 |
| 1902044860 | Bonnie Jaffe | Registered Nurse | 1857 Hapshire Av, St. Paul, MN 55116 | 2009-01-30 |
| Find all providers in zip 55116 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697202 | Kids Zone Autism Center Inc | Clinic/Center | 670 Marigold Ter Ne, Fridley, MN 55432-5641 | 2020-10-18 |
| 1568079374 | Midway Counseling Services LLC | Clinic/Center | 1410 9th Ave S Apt 306, Saint Cloud, MN 56301-5787 | 2020-09-25 |
| 1801409099 | Star Autism Center | Clinic/Center | 3333 W Division St Ste 116, Saint Cloud, MN 56301-4548 | 2020-08-26 |
| 1851900484 | Iron Range Behavioral Services LLC | Clinic/Center | 817 S 5th Ave, Virginia, MN 55792-2804 | 2020-07-29 |
| 1184240103 | Adhd&u | Clinic/Center | 2196 Carter Ave, Saint Paul, MN 55108-1709 | 2020-06-25 |
| 1033744008 | Star Health Services | Clinic/Center | 3055 Old High 8, Saint Anthony, MN 55418 | 2020-03-10 |
| 1659906071 | Amoud Center Inc | Clinic/Center | 1925 Portland Ave, Minneapolis, MN 55404-2713 | 2020-03-05 |
| 1164055026 | Moonlight Support Services LLC | Clinic/Center | 3110 Old Hwy 8, 206, Roseville, MN 55113-5511 | 2020-02-19 |
| 1285279554 | Metro Therapy Center Inc | Clinic/Center | 2520 Pillsbury Ave S Apt 306, Minneapolis, MN 55404-4208 | 2019-11-11 |
| 1710536081 | Blu Care Inc | Clinic/Center | 2910 Pillsbury Ave S Ste 338, Minneapolis, MN 55408 | 2019-09-09 |
| Find all providers with the same taxonomy | ||||
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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.