Organization
BLACKBIRD PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA OCZUS LPC (OWNER)
(608) 631-0911
Entity
Organization
Contact information
Practice address
115 N JACKSON ST STE 100, JANESVILLE, WI 53548-2952
(608) 631-0911
Mailing address
3521 EAGLES RIDGE DR, BELOIT, WI 53511-9108
(608) 290-9841
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528430402
—
WI
Enumeration date
07/14/2021
Last updated
07/14/2021
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