NPIMap

Organization Active NPI

In Bloom Counseling, LLC

  • Mental Health Counselor
  • Bristol, CT
National Provider Identifier
1154856078
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1569 Issued in CT
Legal business name
IN BLOOM COUNSELING, LLC
Practice address
22 Pine St
Suite 205
Bristol, CT 06010-6948
Phone
(203) 626-1605
NPI assigned
Apr 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Authorized official

Name
Deanna Johnson
Title
Owner
Phone
(203) 747-6980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 1569 CT Primary

Addresses

Primary practice location

22 Pine St
Suite 205
Bristol, CT 06010-6948

Mailing address

22 Pine St
Suite 205
Bristol, CT 06010-6948
Phone (203) 626-1605

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1154856078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "address_2": "SUITE 205",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "203-626-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "address_2": "SUITE 205",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "203-626-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN BLOOM COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-747-6980"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "1569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.