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General NPI Number Information
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NPI Number | 1467137521
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Entity Type | Organization
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Legal Business Name | WIRED TO BLOOM THERAPY & CONSULTING, LLC
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 8806 CINCINNATI DAYTON RD
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City | WEST CHESTER
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State | OH
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Zip | 45069-3135
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Country | US
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Telephone | 513-935-1993
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Fax |
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Provider Business Mailing Address
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Address Line | 8806 CINCINNATI DAYTON RD
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City | WEST CHESTER
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State | OH
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Zip | 45069-3135
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Country | US
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Telephone | 513-935-1993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MACHEN CHAMPION
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Credential | LPCC-S, RPT-S
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Telephone | 513-679-1571
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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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