Balance and Blossom Therapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BALANCE AND BLOSSOM THERAPY PLLC

Practice address

511 Eichler Dr Ste 204
West Dundee, IL 60118-2767

Phone

(630) 479-1788

NPI assigned

Jul 22, 2024

Organization subpart

No

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

Authorized official

Name

Jessica Smith, LCSWNPI 1831863877

Title

Owner

Phone

(630) 479-1788

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.

• Jessica Smith

  • Clinical Social Worker
  • Crystal Lake, IL
  • NPI 1831863877
  NPD Authorized official

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1902634934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 EICHLER DR STE 204",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 EICHLER DR STE 204",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182767",
            "telephone_number": "630-479-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE AND BLOSSOM THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-479-1788",
        "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": [],
    "other_names": []
}

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• Clinical Social Worker in West Dundee, IL
• Providers in West Dundee, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.