Provider Demographics
NPI:1932061710
Name:BIRDS BARK, LLC
Entity type:Organization
Organization Name:BIRDS BARK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:VENTULLO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:319-415-2336
Mailing Address - Street 1:123 N LINN ST STE 2D
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2147
Mailing Address - Country:US
Mailing Address - Phone:802-335-2336
Mailing Address - Fax:
Practice Address - Street 1:123 N LINN ST STE 2D
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2147
Practice Address - Country:US
Practice Address - Phone:802-335-2336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty