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General NPI Number Information
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NPI Number | 1114833084
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Entity Type | Organization
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Legal Business Name | BLOOM THEORY BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 15 AVALON DR UNIT 1234
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City | MILFORD
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State | CT
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Zip | 06460-8563
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Country | US
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Telephone | 203-675-3602
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Fax |
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Provider Business Mailing Address
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Address Line | 10 AVALON DR UNIT 3122
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City | MILFORD
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State | CT
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Zip | 06460-8573
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Country | US
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Telephone | 203-675-3602
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ALONA N SCOTT
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Credential | LCSW
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Telephone | 475-449-7021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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