Provider Demographics
NPI:1447134853
Name:BOND & BLOOM
Entity type:Organization
Organization Name:BOND & BLOOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LISW-CP
Authorized Official - Phone:864-251-5171
Mailing Address - Street 1:1641 MASSEY CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-2616
Mailing Address - Country:US
Mailing Address - Phone:864-251-5171
Mailing Address - Fax:
Practice Address - Street 1:1641 MASSEY CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-2616
Practice Address - Country:US
Practice Address - Phone:864-251-5171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty