Organization
BLOSSOM COUNSELING SERVICES LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIYANA SMITH LCSW (OWNER)
(631) 953-3249
Entity
Organization
Contact information
Practice address
40 MONTAUK HWY, SOUTHAMPTON, NY 11968-4119
(631) 953-3249
Mailing address
26 HILL ST STE 114, SOUTHAMPTON, NY 11968-5317
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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