Infinite Blossom Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INFINITE BLOSSOM COUNSELING LLC

Practice address

500 Westgate Dr # 1041
Brockton, MA 02301-1855

Phone

(508) 290-0210

NPI assigned

Jan 31, 2022

Organization subpart

No

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

Authorized official

Name

Mirdith Remy-Valeus, LMHCNPI 1356692826

Title

Owner

Phone

(347) 869-1746

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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, and the practitioner matching its NPPES authorized official.

• Mirdith Remy-Valeus

  • Mental Health Counselor
  • Brockton, MA
  • NPI 1356692826
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1558014589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WESTGATE DR # 1041",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011855",
            "telephone_number": "508-290-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WESTGATE DR # 1041",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011855",
            "telephone_number": "508-290-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE BLOSSOM COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "REMY-VALEUS",
        "authorized_official_first_name": "MIRDITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-869-1746",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mirdith@infiniteblossomcounseling.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "500 Westgate Dr # 1041",
            "city": "Brockton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023011855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Brockton, MA
• Providers in Brockton, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.