NPIMap

Organization Active NPI

Blossom Health Services LLC

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1427555895
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801065043 Issued in MI
Legal business name
BLOSSOM HEALTH SERVICES LLC
Practice address
2156 Glencoe Hills Dr Apt 12
Ann Arbor, MI 48108
Phone
(734) 347-1690
NPI assigned
Apr 11, 2018
Last updated
Jul 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Authorized official

Name
Mary Beth Houpt
Title
Credentialing
Phone
(517) 676-9788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801065043 MI Primary

Addresses

Primary practice location

2156 Glencoe Hills Dr Apt 12
Ann Arbor, MI 48108

Mailing address

PO Box 10
Mason, MI 48854-0010

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1427555895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 GLENCOE HILLS DR APT 12",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-347-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9788"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801065043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.