Provider Demographics
NPI:1952181547
Name:BLUEBIRD COUNSELING OF WESTERN PENNSYLVANIA
Entity Type:Organization
Organization Name:BLUEBIRD COUNSELING OF WESTERN PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-440-7602
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:LARIMER
Mailing Address - State:PA
Mailing Address - Zip Code:15647-0194
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 WEST HEMPFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642
Practice Address - Country:US
Practice Address - Phone:315-480-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty