Wild Blooms Therapy LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

WILD BLOOMS THERAPY LLC

Practice address

5840 N Canton Center Rd Ste 282
Canton, MI 48187-2614

Phone

(734) 905-0940

Fax

(734) 357-0766

NPI assigned

May 20, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Nausheen Masood, PHDNPI 1952966913

Title

Director

Phone

(734) 709-4259

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Nausheen Masood, PHD

  • Clinical Psychologist
  • Canton, MI
  • NPI 1952966913
  NPD Authorized official

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1811554470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 N CANTON CENTER RD STE 282",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872614",
            "telephone_number": "734-905-0940",
            "fax_number": "734-357-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 N CANTON CENTER RD STE 282",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872614",
            "telephone_number": "734-905-0940",
            "fax_number": "734-357-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD BLOOMS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "MASOOD",
        "authorized_official_first_name": "NAUSHEEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "734-709-4259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonnell Whitekus, PHARMD, RPH
• Megan Width, DDS
• Robert Wiedemann
• Sarah Wiegand
• Megan Wieloch, ATC
• Devin Jade Wiley I
• Christine Denise Wilkinson, LPN
• Patricia Lynn Wilkinson, LMSW, ACSW
• Theresa Wilkinson
• Alyssa Brionne Williams

• Clinical Psychologist in Canton, MI
• Providers in Canton, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.