Bloom Women's Counseling, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166.000746 Issued in IL

Legal business name

BLOOM WOMEN'S COUNSELING, LLC

Practice address

122 S Locust St
Suite 5
Sycamore, IL 60178-1865

Phone

(815) 508-6936

Fax

(815) 599-1380

NPI assigned

Mar 21, 2016

Last updated

Mar 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Nelson-Gerhardt, M.S., LMFT

Title

Owner/Manager

Phone

(815) 508-6936

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1275995128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S LOCUST ST",
            "address_2": "SUITE 5",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601781865",
            "telephone_number": "815-508-6936",
            "fax_number": "815-599-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S LOCUST ST",
            "address_2": "SUITE 5",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601781865",
            "telephone_number": "815-508-6936",
            "fax_number": "815-599-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM WOMEN'S COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "NELSON-GERHARDT",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "815-508-6936",
        "authorized_official_credential": "M.S., LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Russell Bishop III, PSY.D.
• Black Lotus Counseling Center
• Darla Lynn Blackbourn, DTV
• Paul J Blaha, DDS MS
• Erin Blair, MS, LMFT
• Magdalena Boba, MS, ANP-BC
• Madilin Bodine
• Russell Jeffrey Bodner, M.D.
• Megan Boehning
• Jesse Boelter, D.C.

• Marriage & Family Therapist in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.