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NPI Code Detail

MEDICARE: BUD & BLOSSOM THERAPEUTICS, LLC

MEDICARE: BUD & BLOSSOM THERAPEUTICS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1972144459
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUD & BLOSSOM THERAPEUTICS, LLC
Provider Business Mailing Address
First Line : 1201 W PEACHTREE ST NW STE 2300
Second Line :
City : ATLANTA
State : GA
Zip : 30309-3453
Country : US
Telephone Number : 407-271-2039
Fax Number :
Provider Business Practice Location Address
First Line : 1201 W PEACHTREE ST NW STE 2300
Second Line :
City : ATLANTA
State : GA
Zip : 30309-3453
Country : US
Telephone Number : 407-271-2039
Fax Number :
Authorized Official
Title or Position : CEO
Name : JAYNE GREEN
Credential : LPC, LMHC, EFCT
Telephone Number : 407-271-2039
Provider Enumeration Date : 10/04/2019
Last Update Date : 05/28/2026

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Directions to “BUD & BLOSSOM THERAPEUTICS, LLC ” Practice Location

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