The Blossom Counseling Center for Personal Growth and Development LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE BLOSSOM COUNSELING CENTER FOR PERSONAL GROWTH AND DEVELOPMENT LLC

Practice address

4829 E Beltline Ave NE Ste 101
Grand Rapids, MI 49525-9349

Phone

(616) 284-1138

NPI assigned

Jan 15, 2026

Organization subpart

No

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

Authorized official

Name

Shayne Delana McNichols, LMSWNPI 1477844678

Title

Therapist

Phone

(616) 284-1138

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.

• Shayne Delana McNichols, LMSW

  • Social Worker
  • Grand Rapids, MI
  • NPI 1477844678
  NPD Authorized official

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

{
    "created_epoch": "1768435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1942169040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 28TH ST SE # 1145",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122049",
            "telephone_number": "616-284-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259349",
            "telephone_number": "616-284-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLOSSOM COUNSELING CENTER FOR PERSONAL GROWTH AND DEVELOPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-15",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "MCNICHOLS",
        "authorized_official_first_name": "SHAYNE",
        "authorized_official_middle_name": "DELANA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "616-284-1138",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.