Bloom Psychological Services, LLC
Organization Active NPI Clinical Psychologist · Gulfport, MS
NPI 1083098495 · NPPES record last updated Jul 15, 2015
Key facts
- NPI
- 1083098495
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 54965 (MS)
- Legal business name
- BLOOM PSYCHOLOGICAL SERVICES, LLC
- Practice address
- 1520 29TH Ave
Suite 31
Gulfport, MS 39501-2843 - Phone
- (228) 547-2273
- NPI assigned
- Jul 15, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Holly Michelle Spotts, PSY.D.
- Title
- Owner
- Phone
- (228) 547-2273
National Provider Directory
Locations
1520 29th Ave
Ste 31
Gulfport, MS 39501
Phone (228) 547-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 54965 | MS | Yes |
Addresses
Primary practice location
1520 29TH Ave
Suite 31
Gulfport, MS 39501-2843
Mailing address
PO Box 1583
Long Beach, MS 39560-1583
Phone (228) 547-2273
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- Ashley Blappert
- Bruce Thompson Bleil
- Michelle M Bliss
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- Michael Alexander Boartfield
- Rylee Bobinger
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All providers in Gulfport, MS · Clinical Psychologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.