Provider Demographics
NPI:1629764204
Name:BLUE FEATHER THERAPY LLC
Entity Type:Organization
Organization Name:BLUE FEATHER THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARADISE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:412-314-1553
Mailing Address - Street 1:927 BROOKLINE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2182
Mailing Address - Country:US
Mailing Address - Phone:412-314-1553
Mailing Address - Fax:412-314-1559
Practice Address - Street 1:927 BROOKLINE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226-2182
Practice Address - Country:US
Practice Address - Phone:412-314-1553
Practice Address - Fax:412-314-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health