Active NPI
Breannah Katrice Davis-Bloom, BCBA, LBA
- Behavior Analyst
- Charleston, SC
National Provider Identifier
1689259145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1 Carriage LN Ste 102
Charleston, SC 29407-6060 - Phone
- (843) 256-8188
- NPI assigned
- Mar 16, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | SC | Primary |
Addresses
Primary practice location
1 Carriage LN Ste 102
Charleston, SC 29407-6060
Mailing address
1 Carriage LN Ste 102
Charleston, SC 29407-6060
Phone (843) 256-8188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1133 | CT | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloom ABA | Behavior Analyst | Current | Accepting new patients |
| ABA Depot LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Goose Creek, SC
- NPI 1407546476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784160000000",
"number": "1689259145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CARRIAGE LN STE 102",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294076060",
"telephone_number": "843-256-8188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CARRIAGE LN STE 102",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294076060",
"telephone_number": "843-256-8188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS-BLOOM",
"first_name": "BREANNAH",
"middle_name": "KATRICE",
"credential": "BCBA, LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-16",
"last_updated": "2026-07-16",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "SC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.