Blossom Therapy LLC
Counselor, Mental Health in Nampa, ID. Organization (NPI-2).
NPI number1801649264
StatusActive
Last updated in NPPESApr 8, 2024
Details
- NPI
- 1801649264
- Entity type
- Organization (NPI-2)
- Legal business name
- Blossom Therapy LLC
- Organization subpart
- No
- Enumeration date
- Apr 8, 2024
- Certification date
- Apr 7, 2024
- Last updated
- Apr 8, 2024
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 |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
320 11th Ave S Ste 204Nampa, ID 83651-5074
Phone 208-614-0908
Mailing address
2316 Sunnybrook Dr Apt 304Nampa, ID 83686-6471
Phone 208-614-0908
Authorized official
Autumn Isaiah Pierce
Owner
2086140908
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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