Provider Demographics
NPI:1427935816
Name:BLUEBIRD THERAPY COLLECTIVE, LLC
Entity type:Organization
Organization Name:BLUEBIRD THERAPY COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOEHNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:701-320-5068
Mailing Address - Street 1:31 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2832
Mailing Address - Country:US
Mailing Address - Phone:701-320-5068
Mailing Address - Fax:
Practice Address - Street 1:8 PLEASANT ST BLDG D
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-5622
Practice Address - Country:US
Practice Address - Phone:701-320-5068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health