The Bloom Wellness and Therapy Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

THE BLOOM WELLNESS AND THERAPY CENTER

Practice address

3343 Peachtree Rd NE Ste 145-1685
Atlanta, GA 30326-1085

Phone

(470) 222-3671

NPI assigned

Feb 3, 2021

Organization subpart

No

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

Authorized official

Name

Edmonia Sianneh Doe, LPCNPI 1659902666

Title

Founder

Phone

(404) 388-0119

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Edmonia Sianneh Doe, M.ED, NCC, LPC

  • Professional Counselor
  • Atlanta, GA
  • NPI 1659902666
  NPD Authorized official
• Dominique Lee

  • Mental Health Counselor
  • Atlanta, GA
  • NPI 1023793270
  NPD

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1841882610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 PEACHTREE RD NE STE 145-1685",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261085",
            "telephone_number": "470-222-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 PEACHTREE RD NE STE 145-1685",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261085",
            "telephone_number": "470-222-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLOOM WELLNESS AND THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "DOE",
        "authorized_official_first_name": "EDMONIA",
        "authorized_official_middle_name": "SIANNEH",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "404-388-0119",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• The Bridges Center
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• Multi-Specialty Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.