Organization Active NPI

Nurture and Bloom Therapy LLC

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1891402996
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
NURTURE AND BLOOM THERAPY LLC
Practice address
4129 NE 40TH Ave
Portland, OR 97211-8233
Phone
(616) 218-3234
NPI assigned
Oct 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Authorized official

Name
Gretchen Klipp, LCSWNPI 1336738996
Title
Licensed Clinical Social Worker
Phone
(616) 218-3234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4129 NE 40TH Ave
Portland, OR 97211-8233

Mailing address

4129 NE 40TH Ave
Portland, OR 97211-8233
Phone (616) 218-3234

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gretchen@nurtureandbloomtherapy.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1891402996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 NE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972118233",
            "telephone_number": "616-218-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 NE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972118233",
            "telephone_number": "616-218-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURTURE AND BLOOM THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-29",
        "status": "A",
        "authorized_official_last_name": "KLIPP",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "616-218-3234",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gretchen@nurtureandbloomtherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4129 NE 40th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972118233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.