Blackbird Psychotherapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BLACKBIRD PSYCHOTHERAPY LLC

Practice address

115 N Jackson St Ste 100
Janesville, WI 53548-2952

Phone

(608) 631-0911

NPI assigned

Jul 14, 2021

Organization subpart

No

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

Authorized official

Name

Alicia Oczus, LPCNPI 1528430402

Title

Owner

Phone

(608) 631-0911

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alicia R Oczus

  • Professional Counselor
  • Janesville, WI
  • NPI 1528430402
  NPD Authorized official
• Kayla A Tucholke, APSW

  • Social Worker
  • Janesville, WI
  • NPI 1306505862
  NPD
• Sabrina Adams

  • Professional Counselor
  • Janesville, WI
  • NPI 1356061360
  NPD (past)

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1467024877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 EAGLES RIDGE DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535119108",
            "telephone_number": "608-290-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N JACKSON ST STE 100",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482952",
            "telephone_number": "608-631-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKBIRD PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "OCZUS",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-631-0911",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528430402",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.blackbirdpsychotherapy.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "115 N Jackson St Ste 100",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535482952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert A. Bisenius, CRNA
• Kimberly Ann Bishop, R.N.
• Tracy M. Bishop, DO
• Catherine A. Bjork, D.D.S.
• Jacob H. Bjork, D.D.S.
• Beth Ann Blakeslee, M.D.
• Dan Blaser
• Leah Blazkovec, OTR
• Bloom Therapy and Wellness, LLC
• Diana M. Bloomberg, LICENSED PRACTICAL N

• Professional Counselor in Janesville, WI
• Providers in Janesville, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.