# BLOSSOM COUNSELING, CO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669120572
- **Authorized official:** CASSIDY SHAIA LCSW (OWNER)
- **Authorized official phone:** (801) 648-5730

## Contact information

- **Practice address:** 11075 S STATE ST STE 14, SANDY, UT 84070-5194
- **Practice address phone:** (801) 648-5730
- **Mailing address:** 11075 S STATE ST STE 14, SANDY, UT 84070-5194
- **Mailing address phone:** (801) 648-5730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 03/10/2022
- **Last updated:** 03/10/2022