Bluevine Behavioral Therapy LLC

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Legal business name

BLUEVINE BEHAVIORAL THERAPY LLC

Practice address

427 N Magnolia Ave
Orlando, FL 32801-1524

Phone

(407) 900-7422

NPI assigned

Feb 12, 2024

Organization subpart

No

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

Authorized official

Name

Yralia DevereuxNPI 1174287684

Title

Owner

Phone

(208) 695-0098

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Yralia Devereux

  • Case Manager/Care Coordinator
  • Winter Garden, FL
  • NPI 1174287684

  Developmental Therapist

  NPD Authorized official

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1821852617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14411 WABASSO LOOP",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875797",
            "telephone_number": "208-695-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 N MAGNOLIA AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011524",
            "telephone_number": "407-900-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEVINE BEHAVIORAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "DEVEREUX",
        "authorized_official_first_name": "YRALIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-695-0098"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.