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General NPI Number Information
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NPI Number | 1740016278
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Entity Type | Organization
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Legal Business Name | BRIDGING BONDS LLC
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Dates
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Enumeration Date | 09/11/2024
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 18-20 LACKAWANNA PLZ STE 200
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3642
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Country | US
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Telephone | 862-261-0215
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Fax | 973-566-1589
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Provider Business Mailing Address
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Address Line | 30 MAPLE AVE APT 1
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City | ROCKAWAY
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State | NJ
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Zip | 07866-3018
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Country | US
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Telephone | 305-764-6223
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YENSY GRAHAM
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Credential | LMFT
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Telephone | 305-764-6223
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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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