Organization
BIRD IN THE MACHINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA KEARLEY LCSW (OWNER)
(813) 451-2161
Entity
Organization
Contact information
Practice address
1219 MILLENNIUM PKWY, BRANDON, FL 33511-3879
(813) 451-2161
Mailing address
1640 CROSSRIDGE DR, BRANDON, FL 33510-2024
(813) 451-2161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487177218
NPI
FL
Enumeration date
12/21/2022
Last updated
12/21/2022
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