Organization
BLOSSOM ABA THERAPY NC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD KAUFMAN (CEO)
(917) 538-7239
Entity
Organization
Contact information
Practice address
322 LAMAR AVE, CHARLOTTE, NC 28204-2436
(732) 730-7505
Mailing address
1235 EAST BLVD STE E1448, CHARLOTTE, NC 28203-5870
(732) 730-7505
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/26/2024
Last updated
02/24/2026
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