Bloom Therapy Center

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

BLOOM THERAPY CENTER

Practice address

1103 Walnut St
Deridder, LA 70634-2731

Phone

(337) 202-0568

NPI assigned

Dec 4, 2024

Last updated

Jan 10, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sarah Brack, MOTNPI 1922713726

Title

Manager, Otr

Phone

(337) 202-0568

Specialties & licenses 2

Addresses

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.

• Sarah Kathleen Brack, LOTR

  • Occupational Therapist
  • Leesville, LA
  • NPI 1922713726
  NPD Authorized official

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1467268490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WALNUT ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342731",
            "telephone_number": "337-202-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WALNUT ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342731",
            "telephone_number": "337-202-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "BRACK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER, OTR",
        "authorized_official_telephone_number": "337-202-0568",
        "authorized_official_credential": "MOT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Kirk Billeaudeaux, R.N.
• Jo Perry Blankenship, R.PH.
• Bliss Day Spa, LLC
• Landon Dale Blood, CCC-SLP
• Maija Lisa Blood
• Edwin R Bonilla, MD
• Cynthia Boswell
• Dustin Boudreaux
• Brighthope Counseling, LLC
• Alisha Brister, OTR/L

• Pediatric Occupational Therapist in Deridder, LA
• Providers in Deridder, LA by specialty
• Pediatric Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.