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General NPI Number Information
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NPI Number | 1275424640
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Entity Type | Organization
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Legal Business Name | TWILIGHT BLOOM COUNSELING PLLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 603 W 14TH ST
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City | AUSTIN
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State | TX
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Zip | 78701-1725
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Country | US
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Telephone | 512-686-8765
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Fax |
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Provider Business Mailing Address
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Address Line | 11121 NIGHT CAMP DR
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City | AUSTIN
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State | TX
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Zip | 78754-6113
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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 | LCSW
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Name | COLLEEN ANN GRINBERG
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Credential | LCSW
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Telephone | 210-542-6001
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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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