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Organization
THE BRIDGE CONSULTING GROUP, LLC
Active
Organization
THE BRIDGE CONSULTING GROUP, LLC
Active
Other names
The Bridge Consulting Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALENCIA BUTLER CHURCH-WILLIAMS ED.D, LBA, QBA (ABA DIRECTOR/CEO)
(919) 491-8611
Entity
Organization
Contact information
Practice address
3790 GUESS RD STE 102, DURHAM, NC 27705-6916
(984) 244-8642
(919) 937-2046
Mailing address
3790 GUESS RD STE 102, DURHAM, NC 27705-6916
(984) 244-8642
(919) 937-2046
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
344600000X
Taxi
—
—
347C00000X
Private Vehicle
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133002469
COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
01
—
10771
QUALIFIED APPLIED BEHAVIOR ANALYSIS CREDENTIALING BOARD (QABA)
—
01
—
11685
QUALIFIED AUTISM SERVICES PROVIDER-SUPERVISOR
—
01
—
1659
NORTH CAROLINA PSYCHOLOGY BOARD
NC
01
—
2346
NORTH CAROLINA PSYCHOLOGY BOARD
NC
01
—
A14394
NORTH CAROLINA BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELOR
NC
Enumeration date
05/11/2020
Last updated
07/24/2023
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