# BLUEBIRD PSYCHOTHERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760848824
- **Authorized official:** IVY VANESSA IRVINE LCSW (OWNER)
- **Authorized official phone:** (406) 546-0082

## Contact information

- **Practice address:** 725 W ALDER ST, SUITE 28, MISSOULA, MT 59802-4036
- **Practice address phone:** (406) 546-0082
- **Mailing address:** PO BOX 1384, LOLO, MT 59847-1384
- **Mailing address phone:** (406) 546-0082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 924 | MT | Yes |

## Other

- **Enumeration date:** 01/05/2016
- **Last updated:** 01/05/2016