MEDICARE: HEAL & BLOSSOM COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1811702988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAL & BLOSSOM COUNSELING LLC

Provider Business Mailing Address
First Line	:	2702 GLENDALE BLVD
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-3982
Country	:	US
Telephone Number	:	219-386-3320
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 GLENDALE BLVD
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-3982
Country	:	US
Telephone Number	:	219-386-3320
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMY COLLIER
Credential	:	LCSW, LCAC
Telephone Number	:	219-386-3320

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	02/07/2025

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