Healthcare Provider Details
I. General information
NPI: 1093633851
Provider Name (Legal Business Name): CHANCE TO BLUME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1502 CENTER ST
BETHLEHEM PA
18018-2507
US
IV. Provider business mailing address
1502 CENTER ST
BETHLEHEM PA
18018-2507
US
V. Phone/Fax
- Phone: 484-282-0338
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CASSANDRA
BLUM
Title or Position: OWNER-OPERATOR
Credential: LCSW
Phone: 484-282-0338