NPIMap

Organization Active NPI

Bloomin Family Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moscow, ID
National Provider Identifier
1457036436
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BLOOMIN FAMILY THERAPY, LLC
Practice address
207 S Main St
Moscow, ID 83843-2807
Phone
(208) 244-1446
NPI assigned
Jun 19, 2023
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Chantel Zuercher, LPC, NCCNPI 1336424134
Title
Owner
Phone
(208) 244-1446

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

207 S Main St
Moscow, ID 83843-2807

Mailing address

1270A SW Center St
Pullman, WA 99163-5388
Phone (208) 244-1446

National Provider Directory

National Provider Directory

Locations

207 S Main St
Moscow, ID 83843
Phone (208) 244-1446

316 S Jefferson St
Moscow, ID 83843
Phone (208) 301-1189

Practitioners & affiliated clinicians

Practitioners 6

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": "1687132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1457036436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270A SW CENTER ST",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635388",
            "telephone_number": "208-244-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S MAIN ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432807",
            "telephone_number": "208-244-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMIN FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "ZUERCHER",
        "authorized_official_first_name": "CHANTEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-244-1446",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.