Sophia Blossom, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

76413 Issued in TX

Practice address

7875 Prospect LN
Bryan, TX 77808-8790

Phone

(832) 568-7522

NPI assigned

Jun 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sophiakornegay@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• David M. Dranetz, M.D., P.L.L.C.

  • Psychiatry Physician
  • College Station, TX
  • NPI 1295263598
  Medicare reassignment
• Grow Empowered, PLLC

  • Mental Health Counselor
  • Houston, TX
  • NPI 1780278721
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Professional

  NPD

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1255825519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 E 29TH ST UNIT 347",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023901",
            "telephone_number": "832-568-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 PROSPECT LN",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778088790",
            "telephone_number": "832-568-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOSSOM",
        "first_name": "SOPHIA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "76413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne D Black, M.D.
• Elizabeth Renee Blackwell, PT
• Katherine E Blalock, M.D.
• Stacie L Blankenship
• Angie Bleike, LPC
• Blue Sky Orthotic and Prosthetics
• Markitta Blue
• Heather Renee Blum, MT
• Bradley Phillip Bogdan, MSW
• Elizabeth Boggess, LPC

• Professional Counselor in Bryan, TX
• Providers in Bryan, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.