MEDICARE: BLUEBIRD PSYCHOLOGICAL SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1629967625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEBIRD PSYCHOLOGICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	7340 OLD MILL TRL
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-3908
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7340 OLD MILL TRL
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-3908
Country	:	US
Telephone Number	:	720-443-0336
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	JOANN VOGELI
Credential	:	PHD
Telephone Number	:	720-443-0336

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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