=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144141870
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THREE BIRDS MENTAL HEALTH SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2026
-----------------------------------------------------
Last Update Date | 07/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2540 HAUSER ROSS DR STE 225 SUITE 225
-----------------------------------------------------
City | SYCAMORE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60178-3176
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-758-8400
-----------------------------------------------------
Fax | 815-758-8441
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2540 HAUSER ROSS DR STE 225
-----------------------------------------------------
City | SYCAMORE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60178-3176
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-758-8400
-----------------------------------------------------
Fax | 815-758-8441
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TRICIA WARD
-----------------------------------------------------
Credential | PMHNP
-----------------------------------------------------
Telephone | 815-758-8400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------