Healthcare Provider Details

I. General information

NPI: 1922164144
Provider Name (Legal Business Name): BLOOMER COUNSELING AND CONSULTING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MADRONA AVE SE
SALEM OR
97302-4609
US

IV. Provider business mailing address

225 MADRONA AVE SE
SALEM OR
97302-4609
US

V. Phone/Fax

Practice location:
  • Phone: 503-362-9466
  • Fax:
Mailing address:
  • Phone: 503-362-9466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number501827
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC1117
License Number StateOR

VIII. Authorized Official

Name: VIVIEN LEAH BLISS
Title or Position: SOLE PROPRIETOR
Credential: MS, LPC, MAC
Phone: 503-362-9466