Bloom Behavioral Therapy LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11284 Issued in SC

Legal business name

BLOOM BEHAVIORAL THERAPY LLC

Practice address

25B Rushmore Dr
Greenville, SC 29615-1254

Phone

(864) 383-0384

NPI assigned

Mar 31, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Madeline Lisa Rehm, LISW-CP

Title

Owner

Phone

(864) 383-0384

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madeline Lisa Hawkins

  • Counselor
  • Greenville, SC
  • NPI 1710361373
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1003312943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25B RUSHMORE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296151254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25B RUSHMORE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296151254",
            "telephone_number": "864-383-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM BEHAVIORAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-31",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "REHM",
        "authorized_official_first_name": "MADELINE",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-383-0384",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "11284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1450",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaelynn Blixt
• Alysa Bloodsworth
• Elizabeth Foster Bloodworth, MD
• James Romey Bloodworth Jr., MD
• Lucian Bloodworth
• Bloom Midwifery LLC
• Molly Bloom
• Blossom Therapy LLC
• Blossoming Hope Counseling
• Gayle Smith Blouin, M.D.

• Mental Health Counselor in Greenville, SC
• Providers in Greenville, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.