Bluebird Avenue Art Therapy and Counseling, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLUEBIRD AVENUE ART THERAPY AND COUNSELING, PLLC

Practice address

6901 Folger Dr
Charlotte, NC 28270-5947

Phone

(704) 942-7888

NPI assigned

Oct 2, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Amy Jill Seitlin, ATR-P, LCMHCANPI 1578187258

Title

Sole Member

Phone

(704) 942-8888

Specialties & licenses 4

Addresses

Practitioners 1

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

• Amy Jill Seitlin, LCMHCA, ATR-P

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1578187258
  NPD Authorized official

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1841897808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 FOLGER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282705947",
            "telephone_number": "704-942-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 FOLGER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282705947",
            "telephone_number": "704-942-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBIRD AVENUE ART THERAPY AND COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "SEITLIN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "704-942-8888",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ATR-P, LCMHCA"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Blueprint Nutrition and Fitness LLC
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• Mental Health Clinic/Center (Including Community Mental Health Center) in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.