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General NPI Number Information
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NPI Number | 1982237269
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Entity Type | Organization
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Legal Business Name | BUILDING BRIDGES
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Dates
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Enumeration Date | 02/14/2020
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 1301 CLIFF RD E
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City | BURNSVILLE
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State | MN
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Zip | 55337-1434
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Country | US
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Telephone | 401-227-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 13327 MORGAN AVE S
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City | BURNSVILLE
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State | MN
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Zip | 55337-6605
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Country | US
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Telephone | 401-227-4343
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | CHARLES SCHUTT
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Credential |
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Telephone | 612-219-7120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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