Active NPI
Phoenix Bloom Family Foundation, Inc.
- Marriage & Family Therapist
- Covington, KY
National Provider Identifier
1013820992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Legal business name
- PHOENIX BLOOM FAMILY FOUNDATION, INC.
- Practice address
- 31 Hideaway Dr
Covington, KY 41017-9775 - Phone
- (859) 307-4540
- NPI assigned
- Sep 23, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tina Nichole Hacker, LMFT, IMFT, LICDC
- Title
- Director
- Phone
- (859) 307-4540
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary | ||
| Public Health or Welfare Agency | 251K00000X |
Addresses
Primary practice location
31 Hideaway Dr
Covington, KY 41017-9775
Mailing address
31 Hideaway Dr
Covington, KY 41017-9775
Phone (859) 307-4540
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Marriage & Family Therapist
- Covington, KY
- NPI 1235738741
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790121600000",
"number": "1013820992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 HIDEAWAY DR",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410179775",
"telephone_number": "859-307-4540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 HIDEAWAY DR",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410179775",
"telephone_number": "859-307-4540"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHOENIX BLOOM FAMILY FOUNDATION, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-23",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A",
"authorized_official_last_name": "HACKER",
"authorized_official_first_name": "TINA",
"authorized_official_middle_name": "NICHOLE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "859-307-4540",
"authorized_official_credential": "LMFT, IMFT, LICDC"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.