Healthcare Provider Details

I. General information

NPI: 1942121041
Provider Name (Legal Business Name): BLUEBIRD THERAPY & WELLNESS CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 FOX RUN
WEST MONROE LA
71291-8136
US

IV. Provider business mailing address

129 FOX RUN
WEST MONROE LA
71291-8136
US

V. Phone/Fax

Practice location:
  • Phone: 318-789-6280
  • Fax:
Mailing address:
  • Phone: 318-789-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: BROOKE MCMILLAN
Title or Position: OWNER/THERAPIST
Credential: LMFT, CCTP
Phone: 318-789-6280