NPIMap

Organization Active NPI

Bloomwell Behavioral Health Inc.

  • Behavior Analyst
  • Raleigh, NC
National Provider Identifier
1275344848
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLOOMWELL BEHAVIORAL HEALTH INC.
Practice address
2910 Sumner Blvd Ste 101
Raleigh, NC 27616-2965
Phone
(919) 391-9087
Fax
(919) 561-6112
NPI assigned
Jan 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Mr. Logan Pratt
Title
Ceo
Phone
(501) 282-0630

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

2910 Sumner Blvd Ste 101
Raleigh, NC 27616-2965

Mailing address

382 NE 191St St Ste 98090
Miami, FL 33179-3899
Phone (501) 282-0630

National Provider Directory

National Provider Directory
Tax ID family
Bloomwell Behavioral Health Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2910 Sumner Blvd
Ste 101
Raleigh, NC 27616
Phone (919) 391-9087

NPI Registry JSON

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1275344848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 NE 191ST ST STE 98090",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331793899",
            "telephone_number": "501-282-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 SUMNER BLVD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162965",
            "telephone_number": "919-391-9087",
            "fax_number": "919-561-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMWELL BEHAVIORAL HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-282-0630",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.