NPIMap

Organization Active NPI

New Bloom Therapy, LLC

  • Professional Counselor
  • Bend, OR
National Provider Identifier
1447846258
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
NEW BLOOM THERAPY, LLC
Practice address
1005 SW Disk Dr Ste 104
Bend, OR 97702-3385
Phone
(541) 248-9903
NPI assigned
Dec 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Authorized official

Name
Sally Lemos, LPCNPI 1790131621
Title
Owner
Phone
(541) 248-9903

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1005 SW Disk Dr Ste 104
Bend, OR 97702-3385

Mailing address

63200 Wishing Well LN
Bend, OR 97701-8272
Phone (541) 248-9903

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.

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1447846258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63200 WISHING WELL LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977018272",
            "telephone_number": "541-248-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 SW DISK DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023385",
            "telephone_number": "541-248-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BLOOM THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "LEMOS",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-248-9903",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.