Healthcare Provider Details

I. General information

NPI: 1710570783
Provider Name (Legal Business Name): BRIDGES TO WELLBEING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S BARTLETT ST STE MEDFORD
MEDFORD OR
97501-7204
US

IV. Provider business mailing address

1314 CENTER DR STE B-406
MEDFORD OR
97501-7908
US

V. Phone/Fax

Practice location:
  • Phone: 541-631-6087
  • Fax:
Mailing address:
  • Phone: 707-623-6911
  • 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: ALICIA MANGIARACINA SCHMIDT
Title or Position: CO OWNER
Credential:
Phone: 541-631-6087