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General NPI Number Information
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NPI Number | 1902762388
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Entity Type | Organization
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Legal Business Name | BRIDGE & BLOOM THERAPY, LLPC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 19306 ECORSE RD STE 103
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City | ALLEN PARK
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State | MI
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Zip | 48101-2262
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Country | US
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Telephone | 734-845-9535
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Fax |
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Provider Business Mailing Address
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Address Line | 19306 ECORSE RD STE 103
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City | ALLEN PARK
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State | MI
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Zip | 48101-2262
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Country | US
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Telephone | 734-845-9535
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Fax |
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Authorized Official
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Title or Position | LICENSED MASTER SOCIAL WORKER
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Name | DIANA SCHEIN
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Credential | LMSW
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Telephone | 734-845-9535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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