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General NPI Number Information
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NPI Number | 1972453678
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Entity Type | Organization
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Legal Business Name | BLOOM THERAPEUTICS, LLC
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 555 S PERRYVILLE RD
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City | ROCKFORD
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State | IL
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Zip | 61108-2522
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Country | US
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Telephone | 815-262-7390
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Fax |
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Provider Business Mailing Address
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Address Line | 1921 WHITESTONE DR
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City | ROCKTON
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State | IL
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Zip | 61072-8005
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Country | US
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Telephone | 815-262-7390
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KATIE SZARZYNSKI
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Credential | LCSW
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Telephone | 815-262-7390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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