Blackbird Psychotherapy Llc | |
115 N Jackson St Ste 100 Janesville WI 53548-2952 | |
(608) 631-0911 | |
Not Available |
Full Name | Blackbird Psychotherapy Llc |
---|---|
Speciality | Counselor - Professional |
Location | 115 N Jackson St Ste 100, Janesville, Wisconsin |
Authorized Official Name and Position | Alicia Oczus (OWNER) |
Authorized Official Contact | 6086310911 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Blackbird Psychotherapy Llc 3521 Eagles Ridge Dr Beloit WI 53511-9108 Ph: (608) 290-9841 | Blackbird Psychotherapy Llc 115 N Jackson St Ste 100 Janesville WI 53548-2952 Ph: (608) 631-0911 |
NPI Number | 1467024877 |
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Provider Enumeration Date | 07/14/2021 |
Last Update Date | 07/14/2021 |
Certification Date | 07/14/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467024877 | NPI | - | NPPES |
1528430402 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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