SOUTHERN BRIDGE INC NPI 1386097848

NPI Information

  • NPI: 1386097848
  • Provider Name: SOUTHERN BRIDGE INC
  • Classification: Marriage & Family Therapist - 106H00000X
  • Entity Type: Organization
  • CLIA Number: 11D2171780
  • Address: 404 CORDER RD STE 300
    WARNER ROBINS, GA
    ZIP 31088
  • Phone: (478) 283-8322

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NPI Details

SOUTHERN BRIDGE INC is a marriage family therapist in Warner Robins, GA. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. SOUTHERN BRIDGE INC NPI is 1386097848. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

404 CORDER RD STE 300
WARNER ROBINS, GA
ZIP 31088-195
Phone: (478) 283-8322
Fax: (877) 712-4794

The provider's authorized official is Neva Danielle Knight Fox .
The authorized official title is Owner and has the following contact phone number (478) 283-8322.

The CLIA number assigned to this NPI record is 11D2171780 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/20/2016 and was last updated on 9/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2106H00000XMarriage & Family TherapistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003222274AMEDICAIDGEORGIA
2003174143AMEDICAIDGEORGIA
3003220322AMEDICAIDGEORGIA
4003209756AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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