MEDICARE: THERAPY IN BLOOM PLLC

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	:	1417800483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY IN BLOOM PLLC

Provider Business Mailing Address
First Line	:	2 BLANEY CIR
Second Line	:
City	:	SEEKONK
State	:	MA
Zip	:	02771-4801
Country	:	US
Telephone Number	:	401-323-7993
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 MARKET ST
Second Line	:
City	:	SWANSEA
State	:	MA
Zip	:	02777-3999
Country	:	US
Telephone Number	:	401-323-7993
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	KAITLYN COGGSHALL
Credential	:	LMHC
Telephone Number	:	401-323-7993

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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