Provider Demographics
NPI:1497528350
Name:ROOTS TO BLOOMS COUNSELING PLLC
Entity Type:Organization
Organization Name:ROOTS TO BLOOMS COUNSELING PLLC
Other - Org Name:CYNTHIA L GASKINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:GASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCS, LCAS, CCS
Authorized Official - Phone:252-514-5861
Mailing Address - Street 1:1822 S. GLENBURNIE RD.
Mailing Address - Street 2:STE 6, PMB 267
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562
Mailing Address - Country:US
Mailing Address - Phone:252-514-5861
Mailing Address - Fax:252-514-5861
Practice Address - Street 1:1115 FULCHER LN
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2413
Practice Address - Country:US
Practice Address - Phone:252-514-5861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty