Bluebird Psychotherapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

924 Issued in MT

Legal business name

BLUEBIRD PSYCHOTHERAPY, PLLC

Practice address

725 W Alder St
Suite 28
Missoula, MT 59802-4036

Phone

(406) 546-0082

NPI assigned

Jan 5, 2016

Organization subpart

No

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

Authorized official

Name

Ivy Vanessa Irvine, LCSWNPI 1467768705

Title

Owner

Phone

(406) 546-0082

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Practitioners 1

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

• Ivy Vanessa Irvine, L.C.S.W.

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1467768705
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1760848824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1384",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "598471384",
            "telephone_number": "406-546-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W ALDER ST",
            "address_2": "SUITE 28",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024036",
            "telephone_number": "406-546-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBIRD PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "IRVINE",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "VANESSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-546-0082",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Kathryn Bloom, FNP-BC
• Nicole M Blubaugh, ATC, LAT
• Blue Cedar Counseling LLC
• Blue Mountain Clinic, Inc.
• Bluebird Medical, LLC
• Ellen Jean Bluett, PHD
• Nathan Dale Blumenbach
• Glenn Blumenson, LCSW
• Anna Joy Boal, DPT, OCS
• Guy Bodfish, DAOM, L.AC.

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.