{
  "npi": "1841920477",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "LAKEDRA",
    "authorized_official_last_name": "RODGERS",
    "authorized_official_middle_name": "J",
    "authorized_official_telephone_number": "3343579183",
    "authorized_official_title_or_position": "owner",
    "certification_date": "2024-09-19",
    "enumeration_date": "2022-06-15",
    "last_updated": "2024-09-19",
    "organization_name": "BLOOM THERAPY",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "6958 BRIGHTWELL LN",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "DORA",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "350622613",
      "state": "AL",
      "telephone_number": "334-357-9183"
    },
    {
      "address_1": "4124 WATERMELON RD STE B",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "NORTHPORT",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "354735252",
      "state": "AL",
      "telephone_number": "334-357-9183"
    }
  ],
  "taxonomies": [
    {
      "code": "101YM0800X",
      "desc": "Counselor, Mental Health",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "E2",
        "medicare_type": "Mental Health Counselor"
      }
    ]
  }
}