Healthcare Provider Details

I. General information

NPI: 1598514085
Provider Name (Legal Business Name): BRIDGING THE GAP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 ARBOR ST UNIT 201
HARTFORD CT
06106-1238
US

IV. Provider business mailing address

34 ROBERTS ST FL 2
NEW BRITAIN CT
06051-3415
US

V. Phone/Fax

Practice location:
  • Phone: 203-455-8060
  • Fax:
Mailing address:
  • Phone: 203-455-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS ALICIA ALAMO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 203-455-8060