Provider Demographics
NPI:1083391296
Name:SEED AND BLOOM THERAPY PLLC
Entity Type:Organization
Organization Name:SEED AND BLOOM THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPEAKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:425-772-0707
Mailing Address - Street 1:16715 NE WOODINVILLE DUVALL RD
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6429
Mailing Address - Country:US
Mailing Address - Phone:425-772-0707
Mailing Address - Fax:
Practice Address - Street 1:5005 200TH ST SW STE B
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6679
Practice Address - Country:US
Practice Address - Phone:425-772-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty