Organization
THE BRIDGES WELLNESS GROUP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN NICKLESON BATTLE JR. LCPC, LPC (CHIEF OPERATING OFFICER)
(703) 225-9118
Entity
Organization
Contact information
Practice address
7050 CHESAPEAKE RD STE 104, HYATTSVILLE, MD 20784
(407) 707-2042
(866) 473-0669
Mailing address
7050 CHESAPEAKE RD STE 104, HYATTSVILLE, MD 20784-2345
(240) 770-7204
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024397355
—
DC
05
—
821004700
—
MD
Enumeration date
04/11/2017
Last updated
05/01/2024
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