Healthcare Provider Details
I. General information
NPI: 1548146822
Provider Name (Legal Business Name): THE BRIDGE COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2025
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4229 LAFAYETTE CENTER DR STE 1200
CHANTILLY VA
20151-1265
US
IV. Provider business mailing address
4229 LAFAYETTE CENTER DR STE 1200
CHANTILLY VA
20151-1265
US
V. Phone/Fax
- Phone: 202-941-7637
- Fax:
- Phone: 202-941-7637
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADAM
MICHAEL
HILLER
Title or Position: OWNER
Credential: LCSW
Phone: 202-941-7637