Bloom Mental Wellness Team LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLOOM MENTAL WELLNESS TEAM LLC

Practice address

345 Doucet Rd Ste 102
Lafayette, LA 70503-3490

Phone

(337) 205-9725

NPI assigned

Aug 24, 2021

Organization subpart

No

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

Authorized official

Name

Katherine Hebert, LCSW

Title

Co Owner

Phone

(337) 354-5578

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1881361244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 NOAH RD",
            "city": "MAURICE",
            "state": "LA",
            "postal_code": "705553065",
            "telephone_number": "337-354-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 DOUCET RD STE 102",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033490",
            "telephone_number": "337-205-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM MENTAL WELLNESS TEAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "337-354-5578",
        "authorized_official_credential": "LCSW"
    },
    "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": []
}

• Marc Christopher Blankenship, DC
• Bradley Michael Blappert, M.D.
• Katharine Blair Bleecher, MS CCC-SLP
• Robert I Blem, M.D.
• Howard P Blevins, PH.D.
• Bloom Speech Therapy, LLC
• Blooming Sunflower Courier Services LLC
• Blossom Therapy LLC
• Jessica Michelle Blount
• Blue Heron Chronic Healthcare

• Mental Health Clinic/Center (Including Community Mental Health Center) in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.