NPIMap

Organization Active NPI

In Bloom Behavioral Health Care

  • Clinical Psychologist
  • Staunton, VA
National Provider Identifier
1104053008
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0015000751 Issued in VA
Legal business name
IN BLOOM BEHAVIORAL HEALTH CARE
Practice address
15 Terry CT
Suite D
Staunton, VA 24401-2568
Phone
(540) 887-2847
Fax
(540) 887-2848
NPI assigned
Jun 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Authorized official

Name
Cindy H Packer
Title
Owner
Phone
(540) 887-2847

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 0015000751 VA Primary

Addresses

Primary practice location

15 Terry CT
Suite D
Staunton, VA 24401-2568

Mailing address

15 Terry CT
Suite D
Staunton, VA 24401-2568
Phone (540) 887-2847

National Provider Directory

National Provider Directory

Locations

15 Terry Ct
Ste D
Staunton, VA 24401
Phone (540) 887-2847

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1104053008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TERRY CT",
            "address_2": "SUITE D",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244012568",
            "telephone_number": "540-887-2847",
            "fax_number": "540-887-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TERRY CT",
            "address_2": "SUITE D",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244012568",
            "telephone_number": "540-887-2847",
            "fax_number": "540-887-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN BLOOM BEHAVIORAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "PACKER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-887-2847"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0015000751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.