The Resilient Bloom LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE RESILIENT BLOOM LLC

Practice address

1701 1St Baxter Xing Ste 201
Fort Mill, SC 29708-8980

Phone

(803) 542-9680

NPI assigned

Apr 23, 2024

Organization subpart

No

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

Authorized official

Name

Kelly Dusek, LPC, LCMHCNPI 1952966681

Title

Manager

Phone

(704) 641-3824

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kelly Sanders Dusek, LPC, LCMHC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1952966681
  NPD Authorized official

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1669227500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15812 WALNUT HILL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282785010",
            "telephone_number": "704-641-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 1ST BAXTER XING STE 201",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088980",
            "telephone_number": "803-542-9680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15812 Walnut Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282785010",
            "country_code": "US",
            "telephone_number": "704-641-3824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE RESILIENT BLOOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "DUSEK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-641-3824",
        "authorized_official_credential": "LPC, LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Dental Office at Fort Mill
• The Dental Office at Fort Mill
• The Healing Collective, LLC
• The Lash Group
• The Olive Tree Wellness Center
• The Triumphant Academy
• Therapy Resource Group
• Therapy World
• Jordan Thomas
• Thompson Child and Family Focus

• Mental Health Counselor in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.