Provider Demographics
NPI:1619746351
Name:BLUEPRINT INTERVENTIONS GROUP
Entity Type:Organization
Organization Name:BLUEPRINT INTERVENTIONS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAKEYA
Authorized Official - Middle Name:
Authorized Official - Last Name:NESBIT-GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-981-5248
Mailing Address - Street 1:PO BOX 870603
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-0016
Mailing Address - Country:US
Mailing Address - Phone:404-931-5738
Mailing Address - Fax:
Practice Address - Street 1:611 LAKEWATER ESTATES LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-4999
Practice Address - Country:US
Practice Address - Phone:404-931-5738
Practice Address - Fax:404-882-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty