| Bloom & Tide, PLLC | |
|
1809 Kilrush Rd Clemmons NC 27012-7914 | |
| (336) 830-7944 | |
| Not Available |
| Full Name | Bloom & Tide, PLLC |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1809 Kilrush Rd, Clemmons, North Carolina |
| Authorized Official Name and Position | Sandra Lea Swindle (MEMBER AND ORGANIZER) |
| Authorized Official Contact | 3368307944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom & Tide, PLLC 1809 Kilrush Rd Clemmons NC 27012-7914 Ph: (336) 830-7944 | Bloom & Tide, PLLC 1809 Kilrush Rd Clemmons NC 27012-7914 Ph: (336) 830-7944 |
| NPI Number | 1386549517 |
|---|---|
| Provider Enumeration Date | 10/08/2026 |
| Last Update Date | 10/08/2026 |
| Certification Date | 10/08/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386549517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Primary |
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