Bluebird Counseling of Lake Country, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BLUEBIRD COUNSELING OF LAKE COUNTRY, LLC

Practice address

148 E Milwaukee St # 1095
Jefferson, WI 53549-1636

Phone

(270) 993-4705

NPI assigned

May 3, 2022

Last updated

May 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Heather E Sorensen, LPC

Title

Therapist/Owner

Phone

(270) 993-4705

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1689319733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 E MILWAUKEE ST # 1095",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535491636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 E MILWAUKEE ST # 1095",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535491636",
            "telephone_number": "270-993-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBIRD COUNSELING OF LAKE COUNTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "270-993-4705",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary K Beck Metzger, APNP
• Heather Christine Bellford, LPC
• Bethany Melissa Berg, APNP
• Alexa Jo Blank
• Lisa Rae Blanton, MS/CCC-SLP
• Barbara Beaudette Bock, FNP
• Mallory L Bohling, RN
• Terrence Christopher Bolger
• Cori Bollinger
• Morgan Borchardt

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.