BLOSSOM FORWARD LLC
NPI 1861081523
Clinic/Center - Mental Health (Including Community Mental Health Center) in Jacksonville, FL

Active since January 15, 2021
9521 SHELLIE RD STE 13, JACKSONVILLE, FL 32257(904) 257-6835 Get Directions Write a Review

NPPES record last updated: September 28, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 28, 2021, Jun 23, 2021, Jan 15, 2021 (3 updates tracked since 2021).

About Blossom Forward Llc NPPES

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

BLOSSOM FORWARD LLC (NPI 1861081523) is a healthcare organization registered as a mental health (including community mental health center) in Jacksonville, Florida and active in the NPI registry since January 2021. The organization lists Brittany Beattie, Ceo/licensed Clinician, as its authorized official.

NPPES Registry Identity

NPI1861081523
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameBLOSSOM FORWARD LLC
Location Address9521 SHELLIE RD STE 13Jacksonville, FL 32257-6174
Mailing Address7977 Sweet Rose LnJacksonville, FL 32244-6175 · (904) 327-7554
Organization SubpartNo
Authorized OfficialBrittany BeattieCeo/licensed Clinician · (904) 327-7554
Enumeration DateJanuary 15, 2021
Last NPPES UpdateSeptember 28, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2021
NPI 1861081523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
9521 SHELLIE RD STE 13, Jacksonville, FL 32257

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Addiction (Substance Use Disorder))
9521 SHELLIE RD STE 13
JACKSONVILLE, FL 32257
Counselor (Addiction (Substance Use Disorder))
9521 SHELLIE RD STE 13
JACKSONVILLE, FL 32257
Counselor (Mental Health)
9521 SHELLIE RD STE 13
JACKSONVILLE, FL 32257

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861081523, enumerated as an "organization" on January 15, 2021.

The provider is located at 9521 SHELLIE RD STE 13 JACKSONVILLE, FL 32257 and the phone number is (904) 257-6835.

Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).