Organization Active NPI

Blooming Roads Counseling, LLC

  • Clinical Social Worker
  • Drums, PA
National Provider Identifier
1104798040
Registry record updated Sep 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BLOOMING ROADS COUNSELING, LLC
Practice address
213 Trapper Springs LN
Drums, PA 18222-1219
Phone
(570) 519-8818
Fax
(570) 990-3029
NPI assigned
Sep 20, 2025
Last updated
Sep 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2025

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

Authorized official

Name
Lisa Marie Medvetz, LCSWNPI 1225794464
Title
Owner/Therapist
Phone
(724) 699-1419

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

213 Trapper Springs LN
Drums, PA 18222-1219

Mailing address

213 Trapper Springs LN
Drums, PA 18222-1219
Phone (570) 519-8818

Other practice location 1

3 E Butler Dr
Drums, PA 18222-2600
Phone (570) 519-8818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260102000061 PA Part B Supplier - Clinic/Group Practice 3870089584 Receives reassigned benefits from 1 practitioner
Practice locations: Drums, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1758326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758326400000",
    "number": "1104798040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 TRAPPER SPRINGS LN",
            "city": "DRUMS",
            "state": "PA",
            "postal_code": "182221219",
            "telephone_number": "570-519-8818",
            "fax_number": "570-990-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 TRAPPER SPRINGS LN",
            "city": "DRUMS",
            "state": "PA",
            "postal_code": "182221219",
            "telephone_number": "570-519-8818",
            "fax_number": "570-990-3029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 E Butler Dr",
            "address_purpose": "LOCATION",
            "city": "Drums",
            "state": "PA",
            "postal_code": "182222600",
            "country_code": "US",
            "telephone_number": "570-519-8818",
            "fax_number": "570-990-3029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLOOMING ROADS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-20",
        "last_updated": "2025-09-20",
        "certification_date": "2025-09-20",
        "status": "A",
        "authorized_official_last_name": "MEDVETZ",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "724-699-1419",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Drums, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.