Audrey Bloom, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61654296 Issued in WA

Practice address

11651 26TH Ave SW
Burien, WA 98146-2402

Phone

(734) 395-0565

NPI assigned

Feb 23, 2023

Last updated

Jun 20, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Transformational Services LLC

  • Clinical Social Worker
  • Plymouth, MI
  • NPI 1780090258
  NPD

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781913600000",
    "number": "1174222624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 D ST STE 100",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982253204",
            "telephone_number": "734-395-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11651 26TH AVE SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981462402",
            "telephone_number": "734-395-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "AUDREY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2026-06-20",
        "certification_date": "2026-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61654296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacey Deann Bleil, RN
• Annette Blevins, MD
• Blissful Knead LLC
• Jennifer L Blomgren
• Jeremiah Blond, LMP
• Colleen Faith Boisjolie, LPN
• Freeha Farhia Bokhari, M.D.
• Nancy Stocks Boldt, RN
• Kelly Marie Bolma
• William Wesley Bomber

• Mental Health Counselor in Burien, WA
• Providers in Burien, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.