Provider Demographics
NPI:1508018847
Name:BLOSSOMING FIGS PSYCHOLOGICAL SERVICES, LLC.
Entity Type:Organization
Organization Name:BLOSSOMING FIGS PSYCHOLOGICAL SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESHUN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-424-6734
Mailing Address - Street 1:PO BOX 957
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-4257
Mailing Address - Country:US
Mailing Address - Phone:570-424-6734
Mailing Address - Fax:570-424-6734
Practice Address - Street 1:223 WASHINGTON ST
Practice Address - Street 2:IST FLOOR OFFICE
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-2862
Practice Address - Country:US
Practice Address - Phone:570-424-6734
Practice Address - Fax:570-424-6734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015651103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001762927OtherHIGHMARK BLUESHIELD
PA2260134OtherCIGNA BEHAVIORAL HEALTH