| Bridging The Gap Counseling Services | |
|
11815 Fountain Way Ste 300 Newport News VA 23606-4448 | |
| (757) 345-0706 | |
| (757) 734-9081 |
| Full Name | Bridging The Gap Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 11815 Fountain Way Ste 300, Newport News, Virginia |
| Authorized Official Name and Position | Diane Joy Green (OWNER) |
| Authorized Official Contact | 7579086082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridging The Gap Counseling Services 11815 Fountain Way Ste 300 Newport News VA 23606-4448 Ph: (757) 908-6082 | Bridging The Gap Counseling Services 11815 Fountain Way Ste 300 Newport News VA 23606-4448 Ph: (757) 345-0706 |
| NPI Number | 1184389082 |
|---|---|
| Provider Enumeration Date | 11/04/2021 |
| Last Update Date | 07/16/2025 |
| Certification Date | 07/16/2025 |
| Medicare PECOS PAC ID | 2961942008 |
|---|---|
| Medicare Enrollment ID | O20240904002947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184389082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Diane Green |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992026249 PECOS PAC ID: 2062851611 Enrollment ID: I20240416002862 |
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