Provider Demographics
NPI:1164247953
Name:BLUEBIRDS COUNSELLING AND RECOVERY SOLUTIONS LLC
Entity type:Organization
Organization Name:BLUEBIRDS COUNSELLING AND RECOVERY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDAHARI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-232-0033
Mailing Address - Street 1:12504 LAKE RIDGE DR STE B
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2393
Mailing Address - Country:US
Mailing Address - Phone:703-232-0033
Mailing Address - Fax:
Practice Address - Street 1:12504 LAKE RIDGE DR STE B
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2393
Practice Address - Country:US
Practice Address - Phone:703-232-0033
Practice Address - Fax:866-820-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty