Blossom Well
Blossom Well is a Professional Counselor in Chicago, Illinois. Registered with an NPI since 2024.
- In the registry since
- 2024
- Specialties on file
- 4
Practice location Address checks out
142 W 62nd StChicago, IL 60621-3809
Phone: (708) 632-1090
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Specialties & licences
| Early Intervention Provider Agency (primary) | Taxonomy 252Y00000X |
|---|---|
| Professional Counselor | Taxonomy 101YP2500X |
| Clinical Social Worker | Taxonomy 1041C0700X |
| Interpreter | Taxonomy 171R00000X |
Record details
| NPI number | 1750122198 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tiffany Lewis — Owner · (708) 632-1090 |
| NPI enumerated | May 31, 2024 |
| Last updated in NPPES | July 6, 2024 |
| Certification date | July 6, 2024 |
| Mailing address | 4193 W Crestline St, Chicago, IL 60652-2923 |
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