Provider Demographics
NPI:1023876356
Name:HUMMINGBIRD BEHAVIORAL HEALTH AND WELLNESS PLLC
Entity type:Organization
Organization Name:HUMMINGBIRD BEHAVIORAL HEALTH AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:IRELAN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:217-681-3290
Mailing Address - Street 1:2501 CHATHAM RD # 4686
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-4188
Mailing Address - Country:US
Mailing Address - Phone:217-681-3290
Mailing Address - Fax:
Practice Address - Street 1:106 W CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:GREENUP
Practice Address - State:IL
Practice Address - Zip Code:62428-1072
Practice Address - Country:US
Practice Address - Phone:217-681-3290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty