NPIMap

Organization Active NPI

Bloom Wellness LLC

  • Mental Health Counselor
  • Woodland Park, CO
National Provider Identifier
1124971205
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BLOOM WELLNESS LLC
Practice address
509 Scott Ave Ste 2D
Woodland Park, CO 80863-1294
Phone
(719) 286-9077
Fax
(719) 431-6193
NPI assigned
Feb 18, 2026
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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
(303) 408-8056

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

509 Scott Ave Ste 2D
Woodland Park, CO 80863-1294

Mailing address

417 Beaver Pond Rd
Divide, CO 80814-7792
Phone (719) 286-9077

Other practice location 1

100 W Bennett Avenue
Cripple Creek, CO 80813
Phone (719) 286-9077

Other practice location 2

10585 Ute Pass Avenue
Green Mountain Falls, CO 80819
Phone (719) 286-9077

National Provider Directory

National Provider Directory
Tax ID family
Bloom Wellness LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1771372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1124971205",
    "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",
            "fax_number": "719-431-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SCOTT AVE STE 2D",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808631294",
            "telephone_number": "719-286-9077",
            "fax_number": "719-431-6193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W Bennett Avenue",
            "address_purpose": "LOCATION",
            "city": "Cripple Creek",
            "state": "CO",
            "postal_code": "80813",
            "country_code": "US",
            "telephone_number": "719-286-9077",
            "fax_number": "719-431-6193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10585 Ute Pass Avenue",
            "address_purpose": "LOCATION",
            "city": "Green Mountain Falls",
            "state": "CO",
            "postal_code": "80819",
            "country_code": "US",
            "telephone_number": "719-286-9077",
            "fax_number": "719-431-6193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLOOM WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-18",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-13",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER, CLINICIAN",
        "authorized_official_telephone_number": "303-408-8056",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.