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General NPI Number Information
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NPI Number | 1205587797
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Entity Type | Organization
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Legal Business Name | FULL BLOOM COUNSELING LLC
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Dates
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Enumeration Date | 01/16/2022
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Last Update Date | 01/16/2022
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Provider Practice Location Address
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Address Line | 38 STONEMILL WAY
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City | SWEDESBORO
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State | NJ
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Zip | 08085-1861
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Country | US
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Telephone | 609-202-1107
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 372
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City | PENNSVILLE
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State | NJ
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Zip | 08070-0372
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Country | US
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Telephone | 609-202-1107
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Fax |
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Authorized Official
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Title or Position | OWNER/ COUNSELOR
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Name | REBECCA LAFLEUR
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Credential | LPC, ACS
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Telephone | 609-202-1107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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