Organization
BRIDGING THE GAP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY BARNETT (QUALIFIED PROFESSIONAL)
(252) 758-1300
Entity
Organization
Contact information
Practice address
205 PLAZA DR, SUITE D, GREENVILLE, NC 27858-6752
(252) 758-1300
(252) 758-0015
Mailing address
205 PLAZA DR, SUITE D, GREENVILLE, NC 27858-6752
(252) 758-1300
(252) 758-0015
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
074-175
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
074-175
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604195
—
NC
05
—
8301920B
—
NC
Enumeration date
01/09/2007
Last updated
02/17/2011
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