Provider Demographics
NPI:1285778217
Name:KAPPER, BLOSSOM D (LCSW)
Entity type:Individual
Prefix:
First Name:BLOSSOM
Middle Name:D
Last Name:KAPPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9026 LYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-2815
Mailing Address - Country:US
Mailing Address - Phone:727-215-8350
Mailing Address - Fax:
Practice Address - Street 1:10825 SEMINOLE BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-3337
Practice Address - Country:US
Practice Address - Phone:727-215-8350
Practice Address - Fax:727-393-7533
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW84161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical