Bridge Vision Licensed Clinical Social Worker - Medicare Mental Health Clinic in San Bernardino, CA

Bridge Vision Licensed Clinical Social Worker is a medicare enrolled mental health clinic (Community/behavioral Health) in San Bernardino, California. The current practice location for Bridge Vision Licensed Clinical Social Worker is 357 W 2nd St Ste 3, San Bernardino, California. For appointments, you can reach them via phone at (909) 936-3888. The mailing address for Bridge Vision Licensed Clinical Social Worker is 255 N D St, Suite 401h, San Bernardino, California and phone number is (909) 936-3888.

Bridge Vision Licensed Clinical Social Worker is licensed to practice in California (license number LCSW29187). The clinic also participates in the medicare program and its NPI number is 1083069850. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (909) 936-3888.

Contact Information

Bridge Vision Licensed Clinical Social Worker
357 W 2nd St Ste 3
San Bernardino
CA 92401-1803
(909) 936-3888
(909) 635-6173

Mental Health Clinic Profile

Full NameBridge Vision Licensed Clinical Social Worker
SpecialityCommunity/Behavioral Health
Location357 W 2nd St Ste 3, San Bernardino, California
Authorized Official Name and PositionColleen Nomsa Chali (CLINICAL DIRECTOR)
Authorized Official Contact9099363888
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Bridge Vision Licensed Clinical Social Worker
255 N D St
Suite 401h
San Bernardino
CA 92401

Ph: (909) 936-3888
Bridge Vision Licensed Clinical Social Worker
357 W 2nd St Ste 3
San Bernardino
CA 92401-1803

Ph: (909) 936-3888

NPI Details:

NPI Number1083069850
Provider Enumeration Date04/29/2016
Last Update Date10/18/2019

Medicare PECOS Information:

Medicare PECOS PAC ID1759718620
Medicare Enrollment IDO20200305002340

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Medical Identifiers

Medical identifiers for Bridge Vision Licensed Clinical Social Worker such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083069850NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
251S00000XCommunity/behavioral Health LCSW29187 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Bridge Vision Licensed Clinical Social Worker acts as a billing entity for following providers:
Provider NameCourtney Roushion
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1568939924
PECOS PAC ID: 9830527894
Enrollment ID: I20200325002076

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Community/Behavioral Health in San Bernardino, CA

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Taylor Almquist Lcsw Inc
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