NPIMap

Organization Active NPI

Bloom Behavior Services LLC

  • Behavior Analyst
  • Washington, MO
National Provider Identifier
1295329654
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLOOM BEHAVIOR SERVICES LLC
Practice address
910 W 14TH St Ste 230
Washington, MO 63090-7003
Phone
(573) 480-0440
NPI assigned
Feb 25, 2021
Last updated
Jan 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Ms. Sally Marie Lavigne, BCBANPI 1437697844
Title
Owner/Bcba
Phone
(573) 480-0440

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

910 W 14TH St Ste 230
Washington, MO 63090-7003

Mailing address

901 W 14TH St Ste 230
Washington, MO 63090-4198
Phone (636) 432-6709

Other practice location 1

266 Ladera Ln
Washington, MO 63090-5763
Phone (573) 480-0440

National Provider Directory

National Provider Directory

Locations

910 W 14th St
Ste 230
Washington, MO 63090
Phone (573) 480-0440

Practitioners & affiliated clinicians

Practitioners 4

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": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1295329654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W 14TH ST STE 230",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904198",
            "telephone_number": "636-432-6709",
            "fax_number": "636-432-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 W 14TH ST STE 230",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630907003",
            "telephone_number": "573-480-0440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "266 Ladera Ln",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630905763",
            "country_code": "US",
            "telephone_number": "573-480-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLOOM BEHAVIOR SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "LAVIGNE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/BCBA",
        "authorized_official_telephone_number": "573-480-0440",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.