Healthcare Provider Details

I. General information

NPI: 1952278228
Provider Name (Legal Business Name): BLOOME HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9955 OSUNA RD NE
ALBUQUERQUE NM
87111-2255
US

IV. Provider business mailing address

PO BOX 20343
ALBUQUERQUE NM
87154-0343
US

V. Phone/Fax

Practice location:
  • Phone: 505-585-2437
  • Fax:
Mailing address:
  • Phone: 505-585-2437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA BLOOME
Title or Position: OWNER
Credential: LPCC
Phone: 505-585-2437