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Organization
BLUEBIRD AVENUE ART THERAPY AND COUNSELING, PLLC
Active
Organization
BLUEBIRD AVENUE ART THERAPY AND COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY JILL SEITLIN ATR-P, LCMHCA (SOLE MEMBER)
(704) 942-8888
Entity
Organization
Contact information
Practice address
6901 FOLGER DR, CHARLOTTE, NC 28270-5947
(704) 942-7888
Mailing address
6901 FOLGER DR, CHARLOTTE, NC 28270-5947
(704) 942-7888
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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