Healthcare Provider Details

I. General information

NPI: 1033033311
Provider Name (Legal Business Name): BLOOM MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4517 PINE TREE CIR STE 6
VESTAVIA AL
35243-2307
US

IV. Provider business mailing address

217 COUNTRY CLUB PARK # 525
MOUNTAIN BRK AL
35213-4237
US

V. Phone/Fax

Practice location:
  • Phone: 205-729-8405
  • Fax:
Mailing address:
  • Phone: 205-729-8405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SAVANNAH LYNN HURT
Title or Position: OWNER
Credential: LICSW
Phone: 205-729-8405