Active NPI
Blossom Community Services
- Community/Behavioral Health Agency
- Gastonia, NC
National Provider Identifier
1447734181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- BLOSSOM COMMUNITY SERVICES
- Practice address
- 1911 Willimax Ave
Gastonia, NC 28054-7440 - Phone
- (704) 780-3082
- NPI assigned
- Sep 19, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Leslie Danielle Dunbar
- Title
- Owner
- Phone
- (704) 780-3082
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | |||
| Secured Medical Transport (VAN) | 343800000X | |||
| Taxi | 344600000X | |||
| Private Vehicle | 347C00000X |
Addresses
Primary practice location
1911 Willimax Ave
Gastonia, NC 28054-7440
Mailing address
1911 Willimax Avenue
Gastonia, NC 28054-7440
Phone (704) 780-3082
Other practice location 1
2450 Aberdeen Blvd
Gastonia, NC 28054-0644
Phone (704) 780-3082
Other practice location 2
2311 Aberdeen Blvd
Gastonia, NC 28054-0601
Phone (704) 780-3082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447734181 | Medicaid | NC |
Other names 1
- Blossom Community Services Inc
National Provider Directory
National Provider Directory- Tax ID family
- Blossom Community Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Addiction (Substance Use Disorder) Counselor
- Charlotte, NC
- NPI 1679125850
Locations
2311 Aberdeen Blvd
Gastonia, NC 28054
Phone (704) 780-3082
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Charlotte, NC
- NPI 1770066128
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733788800000",
"number": "1447734181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 WILLIMAX AVENUE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280547440",
"telephone_number": "704-780-3082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1911 WILLIMAX AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280547440",
"telephone_number": "704-780-3082"
}
],
"practiceLocations": [
{
"address_1": "2450 Aberdeen Blvd",
"address_purpose": "LOCATION",
"city": "Gastonia",
"state": "NC",
"postal_code": "280540644",
"country_code": "US",
"telephone_number": "704-780-3082",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2311 Aberdeen Blvd",
"address_purpose": "LOCATION",
"city": "Gastonia",
"state": "NC",
"postal_code": "280540601",
"country_code": "US",
"telephone_number": "704-780-3082",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "BLOSSOM COMMUNITY SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2018-09-19",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A",
"authorized_official_last_name": "DUNBAR",
"authorized_official_first_name": "LESLIE",
"authorized_official_middle_name": "DANIELLE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "704-780-3082",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "343800000X",
"taxonomy_group": "",
"desc": "Secured Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "344600000X",
"taxonomy_group": "",
"desc": "Taxi",
"state": null,
"license": null,
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447734181",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Blossom Community Services Inc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.