Bloom Children'S Therapy
Occupational Therapist, Pediatrics in Mt Pleasant, SC. Organization (NPI-2).
Details
- NPI
- 1497159446
- Entity type
- Organization (NPI-2)
- Legal business name
- Bloom Children'S Therapy
- Organization subpart
- No
- Enumeration date
- Oct 20, 2014
- Certification date
- Feb 24, 2021
- Last updated
- Feb 24, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XP0200X | Occupational Therapist, Pediatrics | 3326 | SC | Yes |
| 2251P0200X | Physical Therapist, Pediatrics | – | – |
Other names
- Nicole Larose, LLC (Former Legal Business Name)
Practice location
85c Vincent DriveMt Pleasant, SC 29464
Phone 843-425-7963 · Fax 888-588-3421
Mailing address
Bloom Children'S Therapy1154 Elizabeth Ct.
Mt Pleasant, SC 29464
Phone 843-425-7963 · Fax 888-588-3421
Authorized official
Nicole Larose
Owner
8434257963
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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