Provider Demographics
NPI:1386285476
Name:BLUEBIRD COUNSELING OF CENTRAL OHIO L.L.C.
Entity type:Organization
Organization Name:BLUEBIRD COUNSELING OF CENTRAL OHIO L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPANY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:614-389-3814
Mailing Address - Street 1:PO BOX 1421
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216-1421
Mailing Address - Country:US
Mailing Address - Phone:614-753-0836
Mailing Address - Fax:614-389-3841
Practice Address - Street 1:7243 SAWMILL RD STE 105
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-5005
Practice Address - Country:US
Practice Address - Phone:614-389-3814
Practice Address - Fax:614-389-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health