| Blooming You Llc | |
|
10243 Glenburn Ln Charlotte NC 28278-6002 | |
| (417) 501-4689 | |
| Not Available |
| Full Name | Blooming You Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10243 Glenburn Ln, Charlotte, North Carolina |
| Authorized Official Name and Position | Courtney Moore (OWNER/THERAPIST) |
| Authorized Official Contact | 4175014689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blooming You Llc 10243 Glenburn Ln Charlotte NC 28278-6002 Ph: () - | Blooming You Llc 10243 Glenburn Ln Charlotte NC 28278-6002 Ph: (417) 501-4689 |
| NPI Number | 1013775022 |
|---|---|
| Provider Enumeration Date | 03/13/2024 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Medicare PECOS PAC ID | 8224559182 |
|---|---|
| Medicare Enrollment ID | O20250307000772 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013775022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Courtney Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003531617 PECOS PAC ID: 4688195530 Enrollment ID: I20250307000502 |
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