Healthcare Provider Details

I. General information

NPI: 1346158441
Provider Name (Legal Business Name): BLOOM PSYCHIATRIC CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 STEDMAN ST STE 1B
LOWELL MA
01851-2850
US

IV. Provider business mailing address

16 STEDMAN ST STE 1B
LOWELL MA
01851-2850
US

V. Phone/Fax

Practice location:
  • Phone: 781-281-8923
  • Fax:
Mailing address:
  • Phone: 781-281-8923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MONICAH RIVERA
Title or Position: PMHNP
Credential: PMHNP-BC
Phone: 781-281-8923