Valley Birch, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

280957 Issued in WI

Legal business name

VALLEY BIRCH, LLC

Practice address

249 Rittenhouse Avenue
Bayfield, WI 54814

Phone

(715) 779-5678

NPI assigned

Jun 3, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dawn Nixon, PSY.D.

Title

Owner

Phone

(715) 779-5678

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1265812481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 654",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548140654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 RITTENHOUSE AVENUE",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "54814",
            "telephone_number": "715-779-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY BIRCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-779-5678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "280957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Bayfield, WI
• Providers in Bayfield, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.