Full Bloom Therapy Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FULL BLOOM THERAPY SERVICES LLC

Practice address

2600 Tilton Rd # 1014
Egg Harbor Township, NJ 08234-1831

Phone

(732) 640-8593

NPI assigned

Feb 7, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Molly Beth Clarke, LCSW, LCADCNPI 1407307903

Title

Part Owner

Phone

(732) 640-8593

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Molly Beth Clarke, LCSW, LCADC

  • Clinical Social Worker
  • Egg Harbor Township, NJ
  • NPI 1407307903
  NPD Authorized official

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

{
    "created_epoch": "1612656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1295327682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TILTON RD # 1014",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082341831",
            "telephone_number": "732-640-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TILTON RD # 1014",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082341831",
            "telephone_number": "732-640-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL BLOOM THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-07",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "732-640-8593",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, LCADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyasia Fowlkes
• Nicolette Marie Franchetti
• Frederick a. Coville, MD, PC
• Alan Stanley Friedman, MD
• Sarah K Fry, MSN, APN, C.
• Rita Gagliardi, NP
• Michele E Gaguski
• Jaimin Gallagher
• Lisa Gallaher
• Haresh Radheshym Gandhi, MD

• Community/Behavioral Health Agency in Egg Harbor Township, NJ
• Providers in Egg Harbor Township, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.