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General NPI Number Information
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NPI Number | 1891594685
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Entity Type | Organization
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Legal Business Name | BLUE JAY THERAPY LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 810 N HENRY ST STE 430
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City | POST FALLS
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State | ID
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Zip | 83854-7665
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Country | US
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Telephone | 208-254-1416
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Fax |
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Provider Business Mailing Address
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Address Line | 229 E ORCHARD AVE
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City | HAYDEN
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State | ID
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Zip | 83835-9219
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER & THERAPIST
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Name | MADELINE KRAUT
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Credential | LMSW
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Telephone | 208-254-1416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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