Organization
BEIGE BLACKBIRD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICAIAH DANIELLE COPELAND MA (OWNER AND CLINICIAN)
(513) 207-2777
Entity
Organization
Contact information
Practice address
2521 HACKBERRY ST APT 6, CINCINNATI, OH 45206-2143
(513) 207-2777
Mailing address
2521 HACKBERRY ST APT 6, CINCINNATI, OH 45206-2143
(513) 207-2777
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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