NPIMap

Organization Active NPI

Bloom Behavioral Healthcare LLC

  • Behavior Analyst
  • Excelsior Springs, MO
National Provider Identifier
1336896786
Registry record updated Mar 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLOOM BEHAVIORAL HEALTHCARE LLC
Practice address
14405 Salem Rd
Excelsior Springs, MO 64024-8400
Phone
(816) 585-1272
NPI assigned
Mar 6, 2022
Last updated
Mar 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2022

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

Authorized official

Name
Olivia Jo Holt, BCBANPI 1265076939
Title
Co-Owner/Bcba
Phone
(816) 585-1272

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 NU Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

14405 Salem Rd
Excelsior Springs, MO 64024-8400

Mailing address

14405 Salem Rd
Excelsior Springs, MO 64024-8400
Phone (816) 585-1272

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address oholt@bloombhc.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1646524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646524800000",
    "number": "1336896786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14405 SALEM RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640248400",
            "telephone_number": "816-585-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14405 SALEM RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640248400",
            "telephone_number": "816-585-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM BEHAVIORAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-06",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "CO-OWNER/BCBA",
        "authorized_official_telephone_number": "816-585-1272",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oholt@bloombhc.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "14405 Salem Rd",
            "city": "Excelsior Springs",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640248400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Excelsior Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2022; 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.