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NPI Code Detail

MEDICARE: BLOOM COLLECTIVE HEALING LLC

MEDICARE: BLOOM COLLECTIVE HEALING 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1245094796
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLOOM COLLECTIVE HEALING LLC
Provider Business Mailing Address
First Line : 10202 PERKINS ROWE STE E1607231
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-2067
Country : US
Telephone Number : 225-800-2989
Fax Number :
Provider Business Practice Location Address
First Line : 10202 PERKINS ROWE STE E1607231
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-2067
Country : US
Telephone Number : 225-800-2989
Fax Number : 225-521-5153
Authorized Official
Title or Position : OWNER
Name : HEATHER POIRRIER
Credential : LCSW
Telephone Number : 225-800-2989
Provider Enumeration Date : 02/06/2024
Last Update Date : 07/02/2026

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Directions to “BLOOM COLLECTIVE HEALING LLC ” Practice Location

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