Provider Demographics
NPI:1285514877
Name:BLOSSOM BEYOND COUNSELING, LLC
Entity type:Organization
Organization Name:BLOSSOM BEYOND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:TYNESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRYOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LSCSW
Authorized Official - Phone:913-424-9038
Mailing Address - Street 1:5563 NW BARRY RD
Mailing Address - Street 2:PMB 323
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154
Mailing Address - Country:US
Mailing Address - Phone:913-424-9038
Mailing Address - Fax:
Practice Address - Street 1:5563 NW BARRY RD
Practice Address - Street 2:PMB 323
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154
Practice Address - Country:US
Practice Address - Phone:913-424-9038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty