Healthcare Provider Details

I. General information

NPI: 1639015399
Provider Name (Legal Business Name): BLUESPRIG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 SOM CENTER RD
WILLOUGHBY HILLS OH
44094-6501
US

IV. Provider business mailing address

2785 SOM CENTER RD
WILLOUGHBY HILLS OH
44094-6501
US

V. Phone/Fax

Practice location:
  • Phone: 216-278-0288
  • Fax:
Mailing address:
  • Phone: 216-278-0288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: STEFANI JONES
Title or Position: BEHAVIOR TECHNICIAN
Credential:
Phone: 216-338-5751