NPIMap

Organization Active NPI

Bloom Behavioral Consulting, Inc.

  • Behavior Analyst
  • Coral Springs, FL
National Provider Identifier
1417470436
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-14404 Issued in FL
Legal business name
BLOOM BEHAVIORAL CONSULTING, INC.
Practice address
10850 W Sample Rd Apt 6507
Coral Springs, FL 33065-2681
Phone
(954) 856-6926
NPI assigned
Jul 21, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Amanda Rose Bloom, BCBANPI 1518251925
Title
Owner/President
Phone
(954) 856-6926

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-13-14404 FL Primary

Addresses

Primary practice location

10850 W Sample Rd Apt 6507
Coral Springs, FL 33065-2681

Mailing address

10850 W Sample Rd Apt 6507
Coral Springs, FL 33065-2681
Phone (954) 856-6926

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417470436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 W SAMPLE RD APT 6507",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652681",
            "telephone_number": "954-856-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 W SAMPLE RD APT 6507",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652681",
            "telephone_number": "954-856-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM BEHAVIORAL CONSULTING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-856-6926",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-13-14404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

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