Provider Demographics
NPI:1073400560
Name:BLUE RIDGE EXPRESSIVE ARTS, INC.
Entity type:Organization
Organization Name:BLUE RIDGE EXPRESSIVE ARTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:828-773-1365
Mailing Address - Street 1:299 TAMBRAS WAY
Mailing Address - Street 2:
Mailing Address - City:VILAS
Mailing Address - State:NC
Mailing Address - Zip Code:28692-6011
Mailing Address - Country:US
Mailing Address - Phone:828-773-1365
Mailing Address - Fax:
Practice Address - Street 1:379 NEW MARKET BLVD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-3765
Practice Address - Country:US
Practice Address - Phone:828-767-9942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty