Bloom Counseling, PC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4312 Issued in OK

Legal business name

BLOOM COUNSELING, PC

Practice address

3113 Woodside Dr
Ardmore, OK 73401-9118

Phone

(580) 222-7023

NPI assigned

Jun 25, 2010

Last updated

Jun 29, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew W Bloom, LPC

Title

Chief Executive Officer

Phone

(580) 222-7023

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1073824991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 WOODSIDE DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734019118",
            "telephone_number": "580-222-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 WOODSIDE DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734019118",
            "telephone_number": "580-222-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM COUNSELING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "580-222-7023",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Bush Family Eyecare Inc.
• Mikaela Blakemore
• Sharie Blankenship, LPC
• Stephen W Blankenship, BHRS
• Bryce Owen Bliss, M.D.
• Bloom Therapy LLC
• Blue Star Home Care and Hospice LLC
• Lydia Blue
• Board of Education District I-19 Ardmore City Schools
• Wendal Allen Boggs

• Professional Counselor in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.