Grace Blossoms Behavioral Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GRACE BLOSSOMS BEHAVIORAL HEALTH

Practice address

7628 Slate Ridge Blvd
Reynoldsburg, OH 43068-8159

Phone

(614) 354-0464

NPI assigned

Apr 1, 2019

Organization subpart

No

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

Authorized official

Name

Christina RovahNPI 1689112401

Title

Clinical Social Worker

Phone

(614) 354-0464

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 4

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

• Christina R Rovah, LISW-S

  • Clinical Social Worker
  • Reynoldsburg, OH
  • NPI 1689112401
  Medicare reassignment NPD Authorized official
• Elizabeth Gray, LISW

  • Clinical Social Worker
  • Reynoldsburg, OH
  • NPI 1962079269
  NPD
• Carole Crockett-Harris, LISW

  • Clinical Social Worker
  • Westerville, OH
  • NPI 1407004922
  NPD (past)
• Jessica Lane

  • Clinical Social Worker
  • Pataskala, OH
  • NPI 1497522502
  NPD (past)

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1659833655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7628 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688159",
            "telephone_number": "614-354-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7628 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688159",
            "telephone_number": "614-354-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE BLOSSOMS BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "ROVAH",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "614-354-0464"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0345877",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "graceblossoms@icloud.com",
            "affiliation": "N",
            "endpointDescription": "email business",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7628 Slate Ridge Blvd",
            "city": "Reynoldsburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430688159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Clarice Golla, MD
• Raakhee Bansal Gonela, PSY.D., LICDC
• Fernanda C Gonzales Beckford, APRN, FNP-C
• Laurie Denise Gooden
• Megan Nicole Gouhin, FNP-C
• Grace Learnings LLC
• Grace Vision, LLC
• Grace Wiredu
• Graceful Living Home Health LLC
• Graceful Nobility Home LLC

• Clinical Social Worker in Reynoldsburg, OH
• Providers in Reynoldsburg, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.