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General NPI Number Information
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NPI Number | 1912851650
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Entity Type | Organization
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Legal Business Name | LUME & BLOOM PSYCHOTHERAPY
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 86 PINECREST DR UNIT 12D, ESSEX JCT, VT 05452
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City | ESSEX JUNCTION
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State | VT
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Zip | 05452
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Country | US
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Telephone | 802-734-3312
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | ESSEX JCT
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State | VT
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Zip | 05453-0617
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Country | US
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Telephone | 802-734-3312
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Fax | 802-734-3312
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Authorized Official
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Title or Position | OWNER
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Name | BIANCA RAE BLAIKNER
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Credential |
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Telephone | 802-734-3312
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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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