NPIMap

Organization Active NPI

Blossom Therapy LLC

  • Speech-Language Pathologist
  • Greenville, SC
National Provider Identifier
1962020230
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
BLOSSOM THERAPY LLC
Practice address
23 Rock Creek Dr
Greenville, SC 29605-1123
Phone
(864) 918-3195
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Lauren Lea Wickliffe, M.S.P., CCC-SLPNPI 1174906812
Title
Owner
Phone
(864) 918-3195

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
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

23 Rock Creek Dr
Greenville, SC 29605-1123

Mailing address

23 Rock Creek Dr
Greenville, SC 29605-1123
Phone (864) 918-3195

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": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1962020230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ROCK CREEK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051123",
            "telephone_number": "864-918-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ROCK CREEK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051123",
            "telephone_number": "864-918-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "WICKLIFFE",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-918-3195",
        "authorized_official_credential": "M.S.P., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.