Organization Active NPI

Everbloom Therapy Center

  • Community/Behavioral Health Agency
  • Winston Salem, NC
National Provider Identifier
1245190255
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EVERBLOOM THERAPY CENTER
Practice address
301 N Main St Ste 1030
Winston Salem, NC 27101-3819
Phone
(336) 745-1499
NPI assigned
Nov 12, 2025
Last updated
Nov 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Jennifer King
Title
Ceo
Phone
(336) 745-1499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

301 N Main St Ste 1030
Winston Salem, NC 27101-3819

Mailing address

301 N Main St Ste 1030
Winston Salem, NC 27101-3819
Phone (336) 745-1499

National Provider Directory

National Provider Directory

Locations

301 N Main St
Ste 1030
Winston Salem, NC 27101
Phone (336) 745-1499

NPI Registry JSON

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1245190255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N MAIN ST STE 1030",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013819",
            "telephone_number": "336-745-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N MAIN ST STE 1030",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013819",
            "telephone_number": "336-745-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERBLOOM THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-745-1499"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.