Provider Demographics
NPI:1578345633
Name:BLUE DOT PSYCHOTHERAPY PLLC
Entity Type:Organization
Organization Name:BLUE DOT PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-867-8936
Mailing Address - Street 1:13N591 BURLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-8759
Mailing Address - Country:US
Mailing Address - Phone:847-867-8936
Mailing Address - Fax:
Practice Address - Street 1:2325 DEAN ST STE 308
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-4810
Practice Address - Country:US
Practice Address - Phone:847-867-8936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty