Mosaic Bloom Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MOSAIC BLOOM COUNSELING LLC

Practice address

8302 Old York Rd Ste B1
Elkins Park, PA 19027-1529

Phone

(267) 227-0122

NPI assigned

Aug 3, 2023

Organization subpart

No

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

Authorized official

Name

Marquita Janinne Bolden, MSW, LCSWNPI 1801079009

Title

Owner

Phone

(267) 227-0122

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.

• Marquita Janinne Bolden, MSW, LCSW

  • Clinical Social Worker
  • Elkins Park, PA
  • NPI 1801079009
  NPD Authorized official

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1851073241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 OLD YORK RD STE B1",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271529",
            "telephone_number": "267-227-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8302 OLD YORK RD STE B1",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271529",
            "telephone_number": "267-227-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC BLOOM COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "BOLDEN",
        "authorized_official_first_name": "MARQUITA",
        "authorized_official_middle_name": "JANINNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-227-0122",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel K Moon, M.D., M.S.
• Sang J Moon, NP
• Moor Love Home Care Agency LLC
• Aisha Renee Moore, MSW, LCSW
• Andrew Keely Morgan, ATC LAT
• Multicare House Call Physicians, Inc.
• Alice Mungyu
• Jean Ryan Murphy, D.M.D.
• Aubria Nance, EDD, LPC
• Aaron N. Newberg, M.D.

• Clinical Social Worker in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Clinical Social Worker in Pennsylvania

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