Healthcare Provider Details

I. General information

NPI: 1700465275
Provider Name (Legal Business Name): BRIDGING THE GAP THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2021
Last Update Date: 01/30/2022
Certification Date: 01/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 N UNIVERSITY DR STE 500
PLANTATION FL
33324-2009
US

IV. Provider business mailing address

261 N UNIVERSITY DR STE 500
PLANTATION FL
33324-2009
US

V. Phone/Fax

Practice location:
  • Phone: 954-716-2427
  • Fax:
Mailing address:
  • Phone: 954-716-2427
  • 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: BRIDGITTE STUART
Title or Position: CEO
Credential: MS, RBT, LMHC
Phone: 954-716-2427