Provider Demographics
NPI:1417831215
Name:VINE & BLOOM COUNSELING, PLLC
Entity type:Organization
Organization Name:VINE & BLOOM COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CASIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRIG
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, RPT
Authorized Official - Phone:361-401-0777
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:SHINER
Mailing Address - State:TX
Mailing Address - Zip Code:77984-0272
Mailing Address - Country:US
Mailing Address - Phone:361-401-0777
Mailing Address - Fax:
Practice Address - Street 1:1300 CAPTAIN ALBERT MARTIN TRL
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:TX
Practice Address - Zip Code:78629
Practice Address - Country:US
Practice Address - Phone:361-401-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1588282305OtherBEHAVIORAL HEALTH