Healthcare Provider Details

I. General information

NPI: 1740107382
Provider Name (Legal Business Name): BLOOM TRAUMA THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 HARBOR TER
BARTLETT IL
60103-4832
US

IV. Provider business mailing address

629 HARBOR TER
BARTLETT IL
60103-4832
US

V. Phone/Fax

Practice location:
  • Phone: 630-854-3271
  • Fax: 630-854-3271
Mailing address:
  • Phone: 630-854-3271
  • Fax: 630-854-3271

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: IOANA BATZOVA
Title or Position: OWNER/LCPC
Credential: LCPC
Phone: 630-854-3271