NPIMap

Organization Active NPI

Blossom Community Services

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, NC
National Provider Identifier
1679125850
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
BLOSSOM COMMUNITY SERVICES
Doing business as
blossom community services
Practice address
3134 Auten Ave
Charlotte, NC 28269-4599
Phone
(704) 780-3082
NPI assigned
Jul 9, 2019
Last updated
Jul 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Mrs. Leslie Danielle Dunbar, PEER SUPPORT.NPI 1770066128
Title
Certified Subtance Abuse Conserlor
Phone
(704) 780-3082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Mental Health Counselor 101YM0800X
Mental Health Occupational Therapist 225XM0800X

Addresses

Primary practice location

3134 Auten Ave
Charlotte, NC 28269-4599

Mailing address

3134 Auten Ave
Charlotte, NC 28269-4599
Phone (704) 780-3082

Other names 1

  • blossom community services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blossom Community Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1679125850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3134 AUTEN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694599",
            "telephone_number": "704-780-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 AUTEN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694599",
            "telephone_number": "704-780-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "DUNBAR",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "CERTIFIED SUBTANCE ABUSE CONSERLOR",
        "authorized_official_telephone_number": "704-780-3082",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PEER SUPPORT."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "blossom community services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.