Bloominglife LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BLOOMINGLIFE LLC

Practice address

221 Trowbridge St NE Apt 208
Grand Rapids, MI 49503-1891

Phone

(616) 499-7711

NPI assigned

Jun 4, 2019

Organization subpart

No

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

Authorized official

Name

Rebecca Turner, LPCC

Title

Owner

Phone

(616) 275-2288

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BloomingLife LLC Doing business as

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1669030516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 BRETON RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063529",
            "telephone_number": "616-275-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 TROWBRIDGE ST NE APT 208",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031891",
            "telephone_number": "616-499-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMINGLIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-275-2288",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LICENSE",
            "identifier": "6401003114",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BloomingLife LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bloom Behavioral Health Partners PLLC
• Amy Bloom, RD
• Gabrielle Elena Bloom, BCBA
• Haley Bloom
• Kathleen Bloom
• Julie C Blossom-Hartley, MD
• Whitney Blough
• Tracy Elaine Blount, D.D.S
• Shannon Marie Blourne
• Blue Anchor Behavioral Health

• All providers in Grand Rapids, MI
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.