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General NPI Number Information
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NPI Number | 1326954389
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Entity Type | Organization
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Legal Business Name | BLOOM MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 108 S FRANKLIN AVE STE 3
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City | VALLEY STREAM
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State | NY
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Zip | 11580-6105
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Country | US
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Telephone | 347-731-4734
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Fax | 516-303-9925
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Provider Business Mailing Address
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Address Line | 365 CLINTON AVE APT 1B
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City | BROOKLYN
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State | NY
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Zip | 11238-1151
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Country | US
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Telephone | 347-731-4734
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. DEBORAH MICHELLE DEJEAN
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Credential | LMHC
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Telephone | 347-731-4734
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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 |
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License Number State |
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