BLOOM BEHAVIORAL THERAPY LLC NPI 1003312943

NPI Information

NPI: 1003312943
Provider Name: BLOOM BEHAVIORAL THERAPY LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
25B RUSHMORE DR
GREENVILLE, SC
ZIP 29615
Phone: (864) 383-0384
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BLOOM BEHAVIORAL THERAPY LLC is a mental health counselor in Greenville, SC. BLOOM BEHAVIORAL THERAPY LLC NPI is 1003312943. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

25B RUSHMORE DR
GREENVILLE, SC
ZIP 29615-254
Phone: (864) 383-0384

The provider's authorized official is Madeline Lisa Rehm .
The authorized official title is Owner and has the following contact phone number (864) 383-0384.

The enumeration date for this NPI number is 3/31/2018 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	11284	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SW1450	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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