| The Bridge Family Center, Inc | |
|
1022 Farmington Ave West Hartford CT 06107 | |
| (860) 521-8035 | |
| (860) 521-8036 |
| Full Name | The Bridge Family Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1022 Farmington Ave, West Hartford, Connecticut |
| Authorized Official Name and Position | Peter Maltby (CHIEF FISCAL OFFICER) |
| Authorized Official Contact | 8605218035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bridge Family Center, Inc 1022 Farmington Ave West Hartford CT 06107-2105 Ph: (860) 521-8035 | The Bridge Family Center, Inc 1022 Farmington Ave West Hartford CT 06107 Ph: (860) 521-8035 |
| NPI Number | 1689887440 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 01/08/2026 |
| Certification Date | 01/08/2026 |
| Medicare PECOS PAC ID | 1951685064 |
|---|---|
| Medicare Enrollment ID | O20170308001300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689887440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | OPCC-54 (Connecticut) | Primary |
| Provider Name | Kerisha S Prince |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861107591 PECOS PAC ID: 5496127516 Enrollment ID: I20230217001040 |
| Provider Name | Christopher J Dutton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013229939 PECOS PAC ID: 6901335223 Enrollment ID: I20250130002563 |
| Provider Name | Anna M. Leverone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346828191 PECOS PAC ID: 8325533979 Enrollment ID: I20251219003413 |
| Provider Name | Caroline Elizabeth Dumond |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083505184 PECOS PAC ID: 8224523733 Enrollment ID: I20251222003418 |
| Provider Name | Martin Smith |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487008066 PECOS PAC ID: 9234624644 Enrollment ID: I20251223002541 |
| Provider Name | Susan Rylander Toomey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982459814 PECOS PAC ID: 1456847607 Enrollment ID: I20251226001463 |
| Provider Name | Carolyn Burman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730078064 PECOS PAC ID: 6800382078 Enrollment ID: I20251226002073 |
| Provider Name | Carlie Annecchino |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356238125 PECOS PAC ID: 4284110867 Enrollment ID: I20260114000295 |
| Provider Name | Mia S. Kim |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831080753 PECOS PAC ID: 8921584525 Enrollment ID: I20260114000868 |
| Provider Name | Andrew LPC Halpern |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336511559 PECOS PAC ID: 6507347184 Enrollment ID: I20260221000651 |
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The Bridge Family Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1022 Farmington Ave, West Hartford, CT 06107 Phone: 860-561-9635 |
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