Blossoms of Change Counseling LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLOSSOMS OF CHANGE COUNSELING LCSW PLLC

Practice address

343 Oak Neck Rd
West Islip, NY 11795-3616

Phone

(631) 793-5250

NPI assigned

Dec 27, 2023

Last updated

Dec 27, 2023By 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

Courtney A Jacobson, LCSWNPI 1285010108

Title

Sole Member

Phone

(631) 793-5250

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.

• Courtney A Jacobson, LCSW

  • Clinical Social Worker
  • West Islip, NY
  • NPI 1285010108
  NPD Authorized official

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

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1962271262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 OAK NECK RD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953616",
            "telephone_number": "631-793-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 OAK NECK RD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953616",
            "telephone_number": "631-793-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOMS OF CHANGE COUNSELING LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "631-793-5250",
        "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": []
}

• Lisa M Binetti
• Israel Birnbaum, PH.D.
• Kelly A Bivona, LPN
• Taylor Blanket, LMSW
• Steven A Blau, MD
• Kristen Marie Blydenburgh, RPA-C
• Jacqueline Grace Bober, D.O.
• Wojciech Bober, D.O.
• Jill Anne Bocchieri
• Rao Bodapati, MD

• Clinical Social Worker in West Islip, NY
• Providers in West Islip, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.