Bloom Therapeutics, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC6689 Issued in MD

Legal business name

BLOOM THERAPEUTICS, LLC

Practice address

7303 Hanover Pkwy Ste C
Greenbelt, MD 20770-2029

Phone

(240) 758-2142

Fax

(301) 441-2511

NPI assigned

Mar 1, 2018

Last updated

Feb 3, 2022By 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

Mrs. Connie Jones, LCPCNPI 1992248751

Title

Therapist/Owner

Phone

(240) 758-2142

Specialties & licenses 1

Addresses

Locations

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.

• Connie Jones

  • Professional Counselor
  • Greenbelt, MD
  • NPI 1992248751
  NPD Authorized official
• Ellen C Livingston, LCSW-C, LICSW

  • Clinical Social Worker
  • Greenbelt, MD
  • NPI 1881713071
  NPD (past)
• Miesha Damala Scott, LCSW-C

  • Clinical Social Worker
  • Greenbelt, MD
  • NPI 1902075609
  NPD (past)

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1629570056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7303 HANOVER PKWY STE C",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702029",
            "telephone_number": "240-758-2142",
            "fax_number": "240-668-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7303 HANOVER PKWY STE C",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702029",
            "telephone_number": "240-758-2142",
            "fax_number": "301-441-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "240-758-2142",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC6689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lianna Bissell, PMHNP-BC
• Nadege Nkongho Bissong
• Rebecca S Bitzer, MS, RD
• Nicholas Blake
• Kelsey L Blocker, OT
• Andrea Boehm, LCSW-C
• Melissa Bojic, CRNP, FNP-C
• Sidney Boma, HHA
• Quiera Bonds
• Eric Rodrigue Bongni

• Mental Health Counselor in Greenbelt, MD
• Providers in Greenbelt, MD by specialty
• Mental Health Counselor in Maryland

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