Blackbird, Beth Joy

Blackbird, Beth Joy is an individual health care provider with primary practice located at 235 Wealthy St Se , Grand Rapids MI 49503-5299. She recently has only one registered license in Behavioral Health & Social Service Providers / Rehabilitation, which is considered as her primary health care specialty. Blackbird, Beth Joy can be contacted via phone (616) 242-9201.

Contact Information

Primary practice address
235 Wealthy St Se Grand Rapids MI 49503-5299
Phone: (616) 242-9201
Fax: (616) 451-9513
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X 6301010300 Michigan

Profile Details

NPI number 1689631251
LBN Legal business name Blackbird, Beth Joy
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Mar 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689631251 NPPES
Other BB010300 PRIORITY HEALTH BLUE CROS

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