# BRIDGEWELL RESIDENTIAL SERVICES, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** BridgeWell Residential Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396692448
- **Authorized official:** MRS. CANDRA NIKITA EDWARDS LCSW (OWNER, CLINICAL DIRECTOR)
- **Authorized official phone:** (910) 990-1190

## Contact information

- **Practice address:** 2801 MCLAIN ST., GOLDSBORO, NC 27534
- **Practice address phone:** (919) 394-6718
- **Practice address fax:** (919) 288-1276
- **Mailing address:** 112 TIBURON CT, GOLDSBORO, NC 27534-7085
- **Mailing address phone:** (919) 394-6718
- **Mailing address fax:** (919) 288-1276

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2026
- **Last updated:** 08/23/2026