NPIMap

Organization Active NPI

Bloom Therapy LLC

  • Counselor
  • Twin Falls, ID
National Provider Identifier
1720794852
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
BLOOM THERAPY LLC
Practice address
112 Shoshone St. E.Suite 210
Twin Falls, ID 83301-8330
Phone
(208) 420-5336
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Authorized official

Name
Irma Pavlovic, LCSWNPI 1225793771
Title
Owner
Phone
(208) 420-5336

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
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

112 Shoshone St. E.Suite 210
Twin Falls, ID 83301-8330

Mailing address

847 Sun Peak Way
Twin Falls, ID 83301-8977
Phone (208) 420-5336

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": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1720794852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 SUN PEAK WAY",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018977",
            "telephone_number": "208-420-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SHOSHONE ST. E.SUITE 210",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018330",
            "telephone_number": "208-420-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "PAVLOVIC",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-420-5336",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.