# NEUROBLOOM BEHAVIORAL HEALTH, LLC

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

## Provider details

- **NPI number:** 1942164843
- **Authorized official:** DANIELLE STAR HOLZWORTH (OWNER)
- **Authorized official phone:** (910) 545-7561

## Contact information

- **Practice address:** 4441 BRAGG BLVD, FAYETTEVILLE, NC 28303-3862
- **Practice address phone:** (910) 747-3235
- **Practice address fax:** (910) 491-1516
- **Mailing address:** 4441 BRAGG BLVD, FAYETTEVILLE, NC 28303-3862
- **Mailing address phone:** (910) 747-3235
- **Mailing address fax:** (910) 491-1620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | NULL | — |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | — | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | — | — |
| 363LC1500X | Community Health Nurse Practitioner | — | NULL | — |
| 363LC1500X | Community Health Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/15/2025
- **Last updated:** 09/24/2026