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MR. LARRY E. BLOSSOM M.A.
NPI 1366503138
Counselor - Professional in Pueblo, CO

Active since December 13, 2006
611 S UNION AVE APT A, PUEBLO, CO 81004(719) 696-4252 Get Directions Write a Review

NPPES record last updated: April 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 19, 2022, Mar 5, 2020, Jun 22, 2018 (3 updates tracked since 2018).

About Mr. Larry E. Blossom M.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. LARRY E. BLOSSOM M.A. (NPI 1366503138) is an individual professional provider in Pueblo, Colorado, licensed in Virginia (0701002333) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1366503138
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. LARRY E. BLOSSOMCredential: M.A.
Location Address611 S UNION AVE APT APueblo, CO 81004-2250
Mailing Address3225 Independence RdCanon City, CO 81212-9380 · (719) 275-2351 · Fax (719) 269-9386
Phone(719) 696-4252
Sole ProprietorYes
Enumeration DateDecember 13, 2006
Last NPPES UpdateApril 19, 20223 updates tracked since enumeration
NPPES CertifiedApril 19, 2022
✔ NPI 1366503138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in VA · 0701002333
611 S UNION AVE APT A, Pueblo, CO 81004
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Other Identifiers 2

Medicaid5409152VA
Medicaid5409179VA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larry Blossom's NPI number?

The NPI number for Larry Blossom is 1366503138. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Where is Larry Blossom located?

Larry Blossom practices at 611 S Union Ave Apt A, Pueblo, CO 81004. The listed phone number is (719) 696-4252.

What is Larry Blossom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Larry Blossom was last updated on April 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.