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General NPI Number Information
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NPI Number | 1568210755
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Entity Type | Organization
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Legal Business Name | BIRDSONG WELLNESS, INC.
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Dates
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Enumeration Date | 05/11/2024
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 101 H ST STE C MAILBOX 4
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City | ARCATA
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State | CA
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Zip | 95521-6695
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Country | US
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Telephone | 707-683-6260
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 SANTA CLARA ST
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City | EUREKA
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State | CA
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Zip | 95501-0935
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Country | US
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Telephone | 707-683-6260
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRIANNE HALL
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Credential | MS, LPCC, E-RYT
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Telephone | 707-683-6260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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