| The Bridge Counseling And Consultation Center | |
|
761 Poplar St Ste 1k Macon GA 31201-2061 | |
| (478) 957-4482 | |
| Not Available |
| Full Name | The Bridge Counseling And Consultation Center |
|---|---|
| Speciality | Social Worker |
| Location | 761 Poplar St Ste 1k, Macon, Georgia |
| Authorized Official Name and Position | Jada Mcnair Elliott (BUSINESS OWNER) |
| Authorized Official Contact | 4789574482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bridge Counseling And Consultation Center 195 Sun Valley Dr Macon GA 31211-7415 Ph: (478) 957-4482 | The Bridge Counseling And Consultation Center 761 Poplar St Ste 1k Macon GA 31201-2061 Ph: (478) 957-4482 |
| NPI Number | 1346753399 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 02/06/2023 |
| Certification Date | 02/06/2023 |
| Medicare PECOS PAC ID | 0749514388 |
|---|---|
| Medicare Enrollment ID | O20190701002427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346753399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW005145 (Georgia) | Primary |
| Provider Name | Jada Mcnair Elliott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285147231 PECOS PAC ID: 8820322464 Enrollment ID: I20190701002453 |
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