Organization
BLOOM & BALANCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHTIN DICOCHEA LCSW (OWNER)
(910) 705-1698
Entity
Organization
Contact information
Practice address
5 N LAFAYETTE ST STE 3, SHELBY, NC 28150-5687
(980) 552-9374
(980) 552-9275
Mailing address
5 N LAFAYETTE ST STE 3, SHELBY, NC 28150-5687
(910) 705-1698
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/15/2020
Last updated
09/29/2022
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