Bloom Counseling and Wellness

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BLOOM COUNSELING AND WELLNESS

Practice address

3722 Shipyard Blvd Ste a
Wilmington, NC 28403-6165

Phone

(910) 777-8483

NPI assigned

Apr 29, 2024

Organization subpart

No

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

Authorized official

Name

Mary Krenzel, LCMHCNPI 1619252079

Title

Executive Officer

Phone

(248) 835-5175

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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

• Mary Krenzel, LCMHC

  • Professional Counselor
  • Wilmington, NC
  • NPI 1619252079
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720224000000",
    "number": "1518713593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 CROSS WATER CIR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284511519",
            "telephone_number": "910-777-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 SHIPYARD BLVD STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036165",
            "telephone_number": "910-777-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM COUNSELING AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A",
        "authorized_official_last_name": "KRENZEL",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "248-835-5175",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blissful Bridge to Wellness
• Malisa Dawn Blizzard, MSN-RN
• Patrick Thomas Block, CRNA
• Jennifer Blondin, FNP
• Allison W Bloodworth, OD
• Alison Bloom
• Kevin Bloom, PHARM.D.
• Bloomway Behavioral Health & Wellness, PLLC
• Blossom Home Care LLC
• Yolanda Naomi Blount Wood, LPC

• Professional Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.