Healthcare Provider Details
I. General information
NPI: 1932039724
Provider Name (Legal Business Name): NEW BLOOM COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4301 N CLASSEN BLVD STE C
OKLAHOMA CITY OK
73118-5031
US
IV. Provider business mailing address
1500 NE 13TH ST
OKLAHOMA CITY OK
73117-2614
US
V. Phone/Fax
- Phone: 405-414-9195
- Fax:
- Phone: 405-414-9195
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
TEQUIA
SIER
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 405-414-9195