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General NPI Number Information
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NPI Number | 1184570251
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Entity Type | Organization
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Legal Business Name | BLOSSOM & BLOOM WELLNESS SERVICES, PLLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 4030 WAKE FOREST RD STE 349
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City | RALEIGH
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State | NC
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Zip | 27609-0010
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Country | US
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Telephone | 919-400-4138
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 WAKE FOREST RD STE 349
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City | RALEIGH
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State | NC
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Zip | 27609-0010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | SEYI PRECIOUS LASEINDE
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Credential | MA, LPC, LCMHCA,
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Telephone | 984-212-4334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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