Healthcare Provider Details

I. General information

NPI: 1730004680
Provider Name (Legal Business Name): INNER BLOOM COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W 27TH ST
WILMINGTON DE
19802-3510
US

IV. Provider business mailing address

110 W 27TH ST
WILMINGTON DE
19802-3510
US

V. Phone/Fax

Practice location:
  • Phone: 302-593-4494
  • Fax:
Mailing address:
  • Phone: 302-593-4494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JNEA JENKINS
Title or Position: OWNER / LICENSED PROFESSIONAL COUNS
Credential: LPCMH
Phone: 302-593-4494