Blossom ABA Therapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BLOSSOM ABA THERAPY

Practice address

1910 Pacific Ave Suite 2000-1359
Austin, TX 75201

Phone

(216) 215-6495

NPI assigned

Jun 8, 2022

Last updated

Jun 8, 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

Mr. Moshe Nosson Jacobovitch

Title

Manager

Phone

(216) 215-6495

Specialties & licenses 1

Addresses

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.

• Gabrielle Christine Centra-Taylor, BCBA

  • Behavior Analyst
  • Hasbrouck Heights, NJ
  • NPI 1124590344
  NPD (past)

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1841929429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PACIFIC AVE SUITE 2000-1359",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "75201",
            "telephone_number": "216-215-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PACIFIC AVE SUITE 2000-1359",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "75201",
            "telephone_number": "216-215-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM ABA THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "JACOBOVITCH",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_middle_name": "NOSSON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "216-215-6495",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel G Bloom, M.D.
• Virginia Adams Bloom, MED, LPC
• Ginger Ann Bloomer, MD
• Morgan Elizabeth Bloomfield, LMFT
• Maria Suzanne Bosley Bloomquist, MD
• Blossom Acupuncture & Wellness
• Blossom Bridge Home Health LLC
• Meredith Blount, PT
• Whitney Bludworth, MD
• Blue ABA Texas LLC

• Community/Behavioral Health Agency in Austin, TX
• Providers in Austin, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.