Healthcare Provider Details

I. General information

NPI: 1902734023
Provider Name (Legal Business Name): BRIDGE TO THRIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12320 OLD CANAL RD
POTOMAC MD
20854-6238
US

IV. Provider business mailing address

12320 OLD CANAL RD
POTOMAC MD
20854-6238
US

V. Phone/Fax

Practice location:
  • Phone: 301-778-8534
  • Fax:
Mailing address:
  • Phone: 301-778-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. NATALYA SACKS
Title or Position: OWNER
Credential: LCPC
Phone: 301-217-0855