MEDICARE: BLUEBONNET THERAPY SPECIALISTS, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	1041C0700X	Clinical Social Worker
5	106H00000X	Marriage & Family Therapist
6	221700000X	Art Therapist
7	224Z00000X	Occupational Therapy Assistant
8	225100000X	Physical Therapist
9	225200000X	Physical Therapy Assistant
10	225800000X	Recreation Therapist
11	225A00000X	Music Therapist
12	225X00000X	Occupational Therapist
13	2355S0801X	Speech-Language Assistant
14	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1639988728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEBONNET THERAPY SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	260 DORSET LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-4553
Country	:	US
Telephone Number	:	512-773-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	10200 HIGHWAY 290 W STE 101
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78736-7723
Country	:	US
Telephone Number	:	512-710-6861
Fax Number	:	512-222-5283

Authorized Official
Title or Position	:	OWNER
Name	:	KERRI SALVATORE
Credential	:	M.S., CCC-SLP
Telephone Number	:	512-773-7217

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	01/02/2025

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