BRIDGE BEHAVIORAL HEALTH LLC
NPI 1255123147
Nurse Practitioner - Psychiatric/Mental Health in Griffin, GA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bridge Behavioral Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Bridge Behavioral Health LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, GAFrequently 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.
Is Bridge Behavioral Health LLC enrolled in Medicare?
Yes. Bridge Behavioral Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bridge Behavioral Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Bridge Behavioral Health LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 October 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 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.
# Bridge Behavioral Health Llc · NPI 1255123147
Psychiatric/Mental Health organization in Griffin, Georgia. Organization record, active in the CMS NPPES registry since May 19, 2025.
## Identity
- **NPI:** 1255123147 (Entity type: Organization)
- **Enumerated:** May 19, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Ebunoluwa Mikie, CEO AND OWNER
## Practice location
- **Address:** 410 E TAYLOR ST STE K2, Griffin, GA 30223-3444
- **Phone:** (770) 678-0038 · **Fax:** (770) 678-0038
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 3, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1255123147) · Data from the CMS NPPES public registry.