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Organization
THE BLOSSOM COUNSELING CENTER FOR PERSONAL GROWTH AND DEVELOPMENT LLC
Active
Organization
THE BLOSSOM COUNSELING CENTER FOR PERSONAL GROWTH AND DEVELOPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYNE DELANA MCNICHOLS LMSW (THERAPIST)
(616) 284-1138
Entity
Organization
Contact information
Practice address
4829 E BELTLINE AVE NE STE 101, GRAND RAPIDS, MI 49525-9349
(616) 284-1138
Mailing address
5110 28TH ST SE # 1145, GRAND RAPIDS, MI 49512-2049
(616) 284-1138
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/15/2026
Last updated
01/15/2026
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