Provider Demographics
NPI:1033083688
Name:BLUEBIRD THERAPY CENTER LLC
Entity type:Organization
Organization Name:BLUEBIRD THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YONI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-777-7229
Mailing Address - Street 1:126 AYERS CT APT 1C
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5127
Mailing Address - Country:US
Mailing Address - Phone:910-777-7229
Mailing Address - Fax:
Practice Address - Street 1:126 AYERS CT APT 1C
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5127
Practice Address - Country:US
Practice Address - Phone:910-777-7229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health