Mind Bloom Counseling P.L.L.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MIND BLOOM COUNSELING P.L.L.C.

Practice address

215 N Cedar St Ste a
Luverne, MN 56156-1626

Phone

(507) 608-5979

Fax

(507) 607-8774

NPI assigned

Apr 15, 2024

Organization subpart

No

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

Authorized official

Name

Jill Boltjes, MA, LPCCNPI 1083155881

Title

Owner

Phone

(507) 608-5979

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

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.

• Jill Boltjes, LPCC

  • Professional Counselor
  • Luverne, MN
  • NPI 1083155881

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1255185658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 N CEDAR ST",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561318",
            "telephone_number": "507-608-5979",
            "fax_number": "507-607-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N CEDAR ST STE A",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561626",
            "telephone_number": "507-608-5979",
            "fax_number": "507-607-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BLOOM COUNSELING P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "BOLTJES",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-608-5979",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luverne Public School
• Christine Marie Mann, MSW, LICSW, LADC
• Shawna Marshall, MA, LPCC
• George Arthur McDonald, OD
• Vicky Sue Meyer, OTR/L
• Richard J Morgan, M.D.
• Lori J. Mulder, OTR/L
• Rachal Noell, MS, LPCC
• Zachary R Nolz, M.D.
• Oasis Care Home LLC

• Mental Health Counselor in Luverne, MN
• Providers in Luverne, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.