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General NPI Number Information
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NPI Number | 1245094796
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Entity Type | Organization
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Legal Business Name | BLOOM COLLECTIVE HEALING LLC
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 07/05/2025
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Provider Practice Location Address
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Address Line | 10202 PERKINS ROWE STE E1607231
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City | BATON ROUGE
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State | LA
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Zip | 70810-2067
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Country | US
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Telephone | 225-800-2989
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Fax | 225-521-5153
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Provider Business Mailing Address
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Address Line | 10202 PERKINS ROWE STE E1607231
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City | BATON ROUGE
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State | LA
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Zip | 70810-2067
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Country | US
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Telephone | 225-800-2989
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER POIRRIER
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Credential | LCSW
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Telephone | 225-800-2989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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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