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General NPI Number Information
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NPI Number | 1700537743
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Entity Type | Organization
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Legal Business Name | IN BLOOM COUNSELING, PLLC
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 570 LAKE COOK RD STE 117
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City | DEERFIELD
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State | IL
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Zip | 60015-4953
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Country | US
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Telephone | 727-237-6735
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Fax |
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Provider Business Mailing Address
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Address Line | 570 LAKE COOK RD STE 117
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City | DEERFIELD
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State | IL
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Zip | 60015-4953
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Country | US
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Telephone | 847-901-3323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA BLOOM
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Credential | LCPC
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Telephone | 847-901-3323
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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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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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