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General NPI Number Information
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NPI Number | 1184177305
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Entity Type | Organization
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Legal Business Name | BLOOM COUNSELING & FAMILY SERVICES
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Dates
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Enumeration Date | 07/25/2016
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 1020 BAY AREA BLVD STE 118
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City | HOUSTON
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State | TX
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Zip | 77058-2692
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Country | US
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Telephone | 832-224-4490
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 BAY AREA BLVD STE 118
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City | HOUSTON
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State | TX
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Zip | 77058-2692
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Country | US
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Telephone | 832-224-4490
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO
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Name | MS. JUDI E BLOOM
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Credential | MA, LPC-S
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Telephone | 832-224-4490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 62702
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License Number State | TX
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