Healthcare Provider Details

I. General information

NPI: 1710876008
Provider Name (Legal Business Name): BRIDGE BUILDER COUNSELING & CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 UNITED FOUNDERS BLVD STE 222
OKLAHOMA CITY OK
73112-3958
US

IV. Provider business mailing address

3000 UNITED FOUNDERS BLVD STE 222
OKLAHOMA CITY OK
73112-3958
US

V. Phone/Fax

Practice location:
  • Phone: 405-727-0138
  • Fax: 405-242-3213
Mailing address:
  • Phone: 405-727-0138
  • Fax: 405-242-3213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES EARL ROBERSON II
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LPC
Phone: 405-727-0138