Provider Demographics
NPI:1972144459
Name:BUD & BLOSSOM THERAPEUTICS, LLC
Entity type:Organization
Organization Name:BUD & BLOSSOM THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, , LMHC, CAMS II
Authorized Official - Phone:407-271-2039
Mailing Address - Street 1:3919 GARDENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GRANT VALKARIA
Mailing Address - State:FL
Mailing Address - Zip Code:32949-8244
Mailing Address - Country:US
Mailing Address - Phone:407-271-2039
Mailing Address - Fax:
Practice Address - Street 1:5887 GLENRIDGE DR
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5574
Practice Address - Country:US
Practice Address - Phone:404-519-0080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-04
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty