| Bridges Psychiatry Associates | |
|
115 Fairchild St Ste 170 Daniel Island SC 29492-7602 | |
| (803) 339-1563 | |
| (803) 746-7902 |
| Full Name | Bridges Psychiatry Associates |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 115 Fairchild St Ste 170, Daniel Island, South Carolina |
| Authorized Official Name and Position | Daniel J. Balog (DIRECTOR) |
| Authorized Official Contact | 8033391563 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridges Psychiatry Associates 115 Fairchild St Ste 170 Daniel Island SC 29492-7602 Ph: (803) 339-1563 | Bridges Psychiatry Associates 115 Fairchild St Ste 170 Daniel Island SC 29492-7602 Ph: (803) 339-1563 |
| NPI Number | 1366941148 |
|---|---|
| Provider Enumeration Date | 02/07/2018 |
| Last Update Date | 05/05/2022 |
| Certification Date | 05/05/2022 |
| Medicare PECOS PAC ID | 8325467384 |
|---|---|
| Medicare Enrollment ID | O20200924003328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366941148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 37608 (South Carolina) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Donna Clair Orvin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699712539 PECOS PAC ID: 1153222088 Enrollment ID: I20040115000136 |
| Provider Name | David Orvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700940814 PECOS PAC ID: 4385645563 Enrollment ID: I20070131000303 |
| Provider Name | Piave Pitisci Lake |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316075203 PECOS PAC ID: 3678697281 Enrollment ID: I20100903000425 |
| Provider Name | Daniel John Balog |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710036470 PECOS PAC ID: 4688998263 Enrollment ID: I20150130002282 |
| Provider Name | Hector Diaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407818081 PECOS PAC ID: 0941102594 Enrollment ID: I20160321000018 |
| Provider Name | Elizabeth L Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447409735 PECOS PAC ID: 7618237215 Enrollment ID: I20180130001186 |
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