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BLOOM SPEECH THERAPY NPI 1104564384


NPI Information

NPI: 1104564384
Provider Name: BLOOM SPEECH THERAPY
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Address:
105 TOAD RD
COLUMBIA, SC
ZIP 29209
Phone: (803) 260-6253
Get Directions

BLOOM SPEECH THERAPY is a speech language pathologist in Columbia, SC. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. BLOOM SPEECH THERAPY NPI is 1104564384. The provider is registered as an organization entity type.

The provider's business location address is:

105 TOAD RD
COLUMBIA, SC
ZIP 29209-177
Phone: (803) 260-6253
Fax: (855) 202-0515

The provider's authorized official is Courtney Olivia Martin .
The authorized official title is President and has the following contact phone number (803) 260-6253.

The enumeration date for this NPI number is 5/26/2022 and was last updated on 5/26/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251J00000XNursing CareNo
2261QC1500XClinic/CenterCommunity HealthNo
3261QH0700XClinic/CenterHearing and SpeechNo
4261QP0905XClinic/CenterPublic Health, State or LocalNo
5235Z00000XSpeech-Language PathologistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1SA1908MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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