MEDICARE: BLOOM COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1184576019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	2360 WESTMERE DR
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-4702
Country	:	US
Telephone Number	:	317-762-6402
Fax Number	:

Provider Business Practice Location Address
First Line	:	1660 E MAIN ST STE 107B
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-2816
Country	:	US
Telephone Number	:	317-762-6402
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAURYN HOPE MONTGOMERY
Credential	:	LMHC
Telephone Number	:	317-762-6402

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “BLOOM COUNSELING SERVICES, LLC ” Practice Location

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