Bloom Therapy and Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BLOOM THERAPY AND WELLNESS, LLC

Practice address

120 Gantt St Ste 8
Lexington, SC 29072-2811

Phone

(803) 470-4026

NPI assigned

Jul 16, 2020

Last updated

Jul 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea Marie Dorn, MSW, LISW-CPNPI 1336550300

Title

Owner

Phone

(920) 460-6834

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, and the practitioner matching its NPPES authorized official.

• Andrea Marie Dorn, LCSW-IT

  • Clinical Social Worker
  • Lexington, SC
  • NPI 1336550300
  Authorized official Same address or phone

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1760090724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GANTT ST STE 8",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722811",
            "telephone_number": "803-470-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GANTT ST STE 8",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722811",
            "telephone_number": "803-470-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-16",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "DORN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-460-6834",
        "authorized_official_credential": "MSW, LISW-CP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Blatchford, MPT
• Bledsoe Family Medicine LLC
• Horace William Bledsoe, MD
• Donald Lewis Bloodworth III, APRN
• Bloom Pediatric Therapy, LLC
• Ashley May Bloomberg
• Francis Blubaugh
• Blue Heron Wellness LLC
• Karen Small Boatwright
• Gordon H Bobbett II, MD

• Mental Health Counselor in Lexington, SC
• Providers in Lexington, 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 Jul 28, 2022; 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.