BLOOM WELLNESS LLC NPI 1063136968

NPI Information

  • NPI: 1063136968
  • Provider Name: BLOOM WELLNESS LLC
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 2132 W ROSCOE ST
    CHICAGO, IL
    ZIP 60618
  • Phone: (310) 384-3322

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NPI Details

BLOOM WELLNESS LLC is a clinical social worker in Chicago, IL. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. BLOOM WELLNESS LLC NPI is 1063136968. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2132 W ROSCOE ST
CHICAGO, IL
ZIP 60618-241
Phone: (310) 384-3322

The provider's authorized official is Alexandra Marin .
The authorized official title is Founder/owner and has the following contact phone number (310) 384-3322.

The enumeration date for this NPI number is 10/4/2022 and was last updated on 10/4/2022.

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
11041C0700XSocial WorkerClinicalYes

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
11750707394OTHERNPI

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: 11/21/2025

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