Organization Active NPI

Gentle Bloom Therapy

  • Behavior Analyst
  • Covington, GA
National Provider Identifier
1619854106
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GENTLE BLOOM THERAPY
Practice address
50 Channing CT
Covington, GA 30016-5333
Phone
(864) 635-5476
NPI assigned
Aug 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Authorized official

Name
Sha'Kira HicksNPI 1285422832
Title
RBT
Phone
(864) 635-5476

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

50 Channing CT
Covington, GA 30016-5333

Mailing address

50 Channing CT
Covington, GA 30016-5333
Phone (864) 635-5476

Other names 1

  • Gentle Bloom Therapy Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1619854106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CHANNING CT",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300165333",
            "telephone_number": "864-635-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CHANNING CT",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300165333",
            "telephone_number": "864-635-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTLE BLOOM THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "SHA'KIRA",
        "authorized_official_title_or_position": "RBT",
        "authorized_official_telephone_number": "864-635-5476"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Bloom Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.