Provider Demographics
NPI:1902540164
Name:BLOSSOMING HOPE COUNSELING AND CONSULTING PLLC
Entity Type:Organization
Organization Name:BLOSSOMING HOPE COUNSELING AND CONSULTING PLLC
Other - Org Name:BLOSSOMING HOPE COUNSELING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASANDRA
Authorized Official - Middle Name:CHANEL
Authorized Official - Last Name:TOWNSEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-520-2808
Mailing Address - Street 1:111 N ADDISON AVE
Mailing Address - Street 2:203
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-4076
Mailing Address - Country:US
Mailing Address - Phone:773-520-2808
Mailing Address - Fax:
Practice Address - Street 1:111 N ADDISON AVE STE 203
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2862
Practice Address - Country:US
Practice Address - Phone:773-520-2808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty