| Bridging The Gap Counseling Services Llc | |
|
304 Fuller Ter Orange NJ 07050-2414 | |
| (973) 761-3536 | |
| Not Available |
| Full Name | Bridging The Gap Counseling Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 304 Fuller Ter, Orange, New Jersey |
| Authorized Official Name and Position | Kenneth Toussaint (OWNER) |
| Authorized Official Contact | 7188094716 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridging The Gap Counseling Services Llc 4 S Orange Ave # 509 South Orange NJ 07079-1702 Ph: (973) 761-3536 | Bridging The Gap Counseling Services Llc 304 Fuller Ter Orange NJ 07050-2414 Ph: (973) 761-3536 |
| NPI Number | 1205590478 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 11/17/2022 |
| Certification Date | 11/17/2022 |
| Medicare PECOS PAC ID | 9133597396 |
|---|---|
| Medicare Enrollment ID | O20221118000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205590478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kenneth Julian Toussaint |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225656473 PECOS PAC ID: 0042688202 Enrollment ID: I20221118000615 |
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