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General NPI Number Information
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NPI Number | 1841178902
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Entity Type | Organization
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Legal Business Name | BLOOMFIELD COUNSELING AND WELLNESS LLC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 2575 EASTERN BLVD STE 103
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City | YORK
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State | PA
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Zip | 17402-2903
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Country | US
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Telephone | 717-204-8861
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Fax |
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Provider Business Mailing Address
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Address Line | 2575 EASTERN BLVD STE 103
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City | YORK
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State | PA
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Zip | 17402-2903
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Country | US
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Telephone | 717-495-4018
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Fax |
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Authorized Official
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Title or Position | OWNER & CLINICIAN
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Name | STACEY BURROUGHS
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Credential | LPC
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Telephone | 717-495-4018
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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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