| Bridges Community Support Services | |
|
3155 Sutton Blvd Ste 201 Maplewood MO 63143-3917 | |
| (314) 781-7900 | |
| (314) 781-7914 |
| Full Name | Bridges Community Support Services |
|---|---|
| Speciality | Counselor |
| Location | 3155 Sutton Blvd Ste 201, Maplewood, Missouri |
| Authorized Official Name and Position | Barry J Larson (PRESIDENT) |
| Authorized Official Contact | 3147817900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridges Community Support Services 3155 Sutton Blvd Ste 201 Maplewood MO 63143-3917 Ph: (314) 781-7900 | Bridges Community Support Services 3155 Sutton Blvd Ste 201 Maplewood MO 63143-3917 Ph: (314) 781-7900 |
| NPI Number | 1427226612 |
|---|---|
| Provider Enumeration Date | 02/11/2008 |
| Last Update Date | 09/28/2022 |
| Certification Date | 09/28/2022 |
| Medicare PECOS PAC ID | 2961418629 |
|---|---|
| Medicare Enrollment ID | O20060306000008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427226612 | NPI | - | NPPES |
| 503292203 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Theresa M Owens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275686578 PECOS PAC ID: 2466610316 Enrollment ID: I20120223000043 |
| Provider Name | Holly E Turk Collier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962868018 PECOS PAC ID: 3577868629 Enrollment ID: I20160226001502 |
| Provider Name | Kelly Marie Bauman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952955338 PECOS PAC ID: 3476880519 Enrollment ID: I20190812002673 |
| Provider Name | Catherine Christine Wilke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720528821 PECOS PAC ID: 4082033345 Enrollment ID: I20201006001739 |
| Provider Name | Judy A Seltzer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205379781 PECOS PAC ID: 8729437967 Enrollment ID: I20231213000263 |
| Provider Name | Polly Ann Sharp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871633511 PECOS PAC ID: 7113376005 Enrollment ID: I20231218003691 |
| Provider Name | Cynthia Susan Rohlfing Dodson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386284065 PECOS PAC ID: 3779926217 Enrollment ID: I20240212002380 |
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