Healthcare Provider Details

I. General information

NPI: 1942160536
Provider Name (Legal Business Name): BRIDGES TO WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1344 NW 98TH ST
OKEECHOBEE FL
34972-0851
US

IV. Provider business mailing address

1344 NW 98TH ST
OKEECHOBEE FL
34972-0851
US

V. Phone/Fax

Practice location:
  • Phone: 863-532-2060
  • Fax:
Mailing address:
  • Phone: 863-532-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. BONNIE JEANETTE RUSSO
Title or Position: PRESIDENT
Credential: LCSW
Phone: 772-310-3921