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General NPI Number Information
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NPI Number | 1568038222
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Entity Type | Organization
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Legal Business Name | BRIDGEWAY CENTER INC
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 205 SHELL AVE SE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-5808
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Country | US
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Telephone | 850-833-7500
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Fax | 850-833-7528
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Provider Business Mailing Address
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Address Line | 137 HOSPITAL DR NE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-5015
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Country | US
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Telephone | 850-833-3975
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Fax | 850-883-7582
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. BONNIE R BARLOW
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Credential |
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Telephone | 850-833-3975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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