MEDICARE: NEURO BLOOM AND COMPANY 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1396691507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEURO BLOOM AND COMPANY LLC

Provider Business Mailing Address
First Line	:	8041 LINFIELD WAY
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-5060
Country	:	US
Telephone Number	:	334-596-5566
Fax Number	:

Provider Business Practice Location Address
First Line	:	8041 LINFIELD WAY
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-5060
Country	:	US
Telephone Number	:	334-596-5566
Fax Number	:

Authorized Official
Title or Position	:	CEO, CLINICAL THERAPIST
Name	:	HANNAH E SANFORD
Credential	:	LPC
Telephone Number	:	334-596-5566

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “NEURO BLOOM AND COMPANY LLC ” Practice Location

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