Blossom Counseling Center PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLOSSOM COUNSELING CENTER PLLC

Practice address

1030 Lanterns LN
Leland, NC 28451-9381

Phone

(910) 442-6000

NPI assigned

Sep 16, 2022

Last updated

Sep 16, 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

Valencia J Sanders-Davis, LCMHCNPI 1912242173

Title

Owner

Phone

(910) 442-6000

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.

• Valencia Juanita Sanders-Davis, LPC

  • Mental Health Counselor
  • High Point, NC
  • NPI 1912242173
  NPD Authorized official

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1942922828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 LANTERNS LN",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284519381",
            "telephone_number": "910-442-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 LANTERNS LN",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284519381",
            "telephone_number": "910-442-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM COUNSELING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "SANDERS-DAVIS",
        "authorized_official_first_name": "VALENCIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-442-6000",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Leland, NC
• Providers in Leland, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.