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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

BRIDGE BEHAVIORAL HEALTH LLC
NPI 1255123147
Nurse Practitioner - Psychiatric/Mental Health in Griffin, GA

Active since May 19, 2025CLIA 11D2336910 · Waiver
410 E TAYLOR ST STE K2, GRIFFIN, GA 30223(770) 678-0038(770) 678-0038 Get Directions Write a Review

NPPES record last updated: July 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 11, 2026, Jun 4, 2025, May 19, 2025 (3 updates tracked since 2025).

About Bridge Behavioral Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRIDGE BEHAVIORAL HEALTH LLC (NPI 1255123147) is a healthcare organization registered as a psychiatric/mental health in Griffin, Georgia and active in the NPI registry since May 2025. The organization holds a CLIA Waiver certificate valid through January 12, 2028 and lists Ebunoluwa Mikie, Ceo And Owner, as its authorized official.

NPPES Registry Identity

NPI1255123147
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameBRIDGE BEHAVIORAL HEALTH LLC
Location Address410 E TAYLOR ST STE K2Griffin, GA 30223-3444
Mailing Address164 Al Jennah BlvdLocust Grove, GA 30248-3753 · (770) 678-0038 · Fax (770) 796-7726
Phone(770) 678-0038
Fax(770) 678-0038
Organization SubpartNo
Authorized OfficialEbunoluwa MikieCeo And Owner · (404) 917-5484
Enumeration DateMay 19, 2025
Last NPPES UpdateJuly 11, 20263 updates tracked since enumeration
NPPES CertifiedJuly 11, 2026
✔ NPI 1255123147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
410 E TAYLOR ST STE K2, Griffin, GA 30223
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2336910

Bridge Behavioral Health · Griffin, GA
Active · expires Jan 12, 2028
CLIA Number11D2336910
Laboratory TypePhysician Office
Certificate Effective DateJanuary 13, 2026
Certificate Expiration DateJanuary 12, 2028
Laboratory DirectorDr. Ebunoluwa Mikie
Laboratory Phone(770) 678-0038
Laboratory LocationBridge Behavioral Health324 E Broad Street, Suite 109 B, Griffin, GA 30223
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EBUNOLUWA MIKIE
Nurse Practitioner (Psychiatric/Mental Health)
410 E TAYLOR ST STE K2
GRIFFIN, GA 30223
Spalding County (770) 678-0038

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bridge Behavioral Health LLC's NPI number?

The NPI number for Bridge Behavioral Health LLC is 1255123147. It was assigned to this organization in the NPPES registry on May 19, 2025.

Where is Bridge Behavioral Health LLC located?

Bridge Behavioral Health LLC is located at 410 E Taylor St Ste K2, Griffin, GA 30223. The listed phone number is (770) 678-0038.

What is Bridge Behavioral Health LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Does Bridge Behavioral Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2336910) is associated with this NPI, valid through January 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bridge Behavioral Health LLC was last updated on July 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.