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General NPI Number Information
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NPI Number | 1205419934
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Entity Type | Organization
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Legal Business Name | CRESCENT BLOOM CONSULTING LLC
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 1021 THALIA ST
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City | NEW ORLEANS
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State | LA
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Zip | 70130-4134
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Country | US
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Telephone | 504-252-0251
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 THALIA ST
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City | NEW ORLEANS
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State | LA
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Zip | 70130-4134
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | REBEKAH CIANCI
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Credential | BCBA, LBA, LPC
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Telephone | 630-816-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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