Full Bloom Therapy & Consulting

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

FULL BLOOM THERAPY & CONSULTING

Practice address

9 Bowdoin Mill Is
Topsham, ME 04086-1263

Phone

(207) 837-6599

NPI assigned

Feb 14, 2019

Last updated

Nov 5, 2023By 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

Stacey Michelle Jenkins, LCPCNPI 1780018119

Title

Owner

Phone

(207) 837-6599

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Stacey Jenkins, LCPC

  • Professional Counselor
  • Topsham, ME
  • NPI 1780018119
  NPD Authorized official

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699142400000",
    "number": "1770049769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BOWDOIN MILL IS",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861263",
            "telephone_number": "207-837-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BOWDOIN MILL IS",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861263",
            "telephone_number": "207-837-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL BLOOM THERAPY & CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2023-11-05",
        "certification_date": "2023-11-05",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-837-6599",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780018119",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Francis, NP
• Christopher Frank
• Frederick a Findlen DMD PA
• Frederick J. Wigand, DDS, P.C.
• From the Heart Care Network LLC
• William Furber
• Delaney Ryanne Gaetano, PT, DPT
• Kayla Christine Gagne
• Ethan Clarence Gagnon
• Aubrey C Gail, DC

• Adolescent and Children Mental Health Clinic/Center in Topsham, ME
• Providers in Topsham, ME by specialty
• Adolescent and Children Mental Health Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2023; 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.