Bloom Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLOOM WELLNESS LLC

Practice address

10585 Ute Pass Avenue
Green Mountain Falls, CO 80809

Phone

(719) 286-9077

NPI assigned

Feb 24, 2025

Organization subpart

Yes

Parent organization

BLOOM WELLNESS LLCAs reported in NPPES

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

Authorized official

Name

Laura Magnuson, LCSWNPI 1881093839

Title

Owner/Clinician

Phone

(719) 286-9077

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bloom Wellness LLC

  • Clinical Social Worker
  • Woodland Park, CO
  • NPI 1760177919

  O20230927003392

  Same enrollment

Tax ID family

Bloom Wellness LLC5 organizations share this tax ID, including this one

Part of

Bloom Wellness LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Bloom Wellness LLC

  • Clinical Social Worker
  • Cripple Creek, CO
  • NPI 1093523904
  NPD tax ID
• Bloom Wellness LLC

  • Mental Health Counselor
  • Woodland Park, CO
  • NPI 1124971205
  NPD tax ID
• Bloom Wellness LLC

  • Clinical Social Worker
  • Woodland Park, CO
  • NPI 1760177919
  NPD tax ID
• Bloom Wellness LLC

  • Mental Health Counselor
  • Woodland Park, CO
  • NPI 1881516581
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Magnuson, MSW, LSW

  • Mental Health Counselor
  • Denver, CO
  • NPI 1881093839
  NPD Authorized official
• Timothy Lee Corbley, LCSW

  • Clinical Social Worker
  • Green Mountain Falls, CO
  • NPI 1114630977
  NPD
• Deborah B Elliott, LCSW

  • Clinical Social Worker
  • Woodland Park, CO
  • NPI 1306215629
  NPD

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1114723558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 BEAVER POND RD",
            "city": "DIVIDE",
            "state": "CO",
            "postal_code": "808147792",
            "telephone_number": "719-286-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10585 UTE PASS AVENUE",
            "city": "GREEN MOUNTAIN FALLS",
            "state": "CO",
            "postal_code": "80809",
            "telephone_number": "719-286-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLOOM WELLNESS LLC",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "719-286-9077",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Albrecht, PT
• Robyn Marie Baumgartner, DPT
• Lori Ann Beard, PT
• Kevin Bishop, LCSW
• Orrin Odell Childers Jr.
• Childrens Ark, Inc
• Timothy Lee Corbley, LCSW
• Everly Home Health Care, Inc.
• Mary Patrice Fehn, L.C.S.W.

• Clinical Social Worker in Green Mountain Falls, CO
• Providers in Green Mountain Falls, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.