MEDICARE: BLOOM WITHIN COUNSELING AND THERAPEUTIC SERVICES

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	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1598617136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM WITHIN COUNSELING AND THERAPEUTIC SERVICES

Provider Business Mailing Address
First Line	:	4830 MONTCLAIR HILL LN
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-2036
Country	:	US
Telephone Number	:	318-608-0273
Fax Number	:	318-608-0273

Provider Business Practice Location Address
First Line	:	4830 MONTCLAIR HILL LN
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-2036
Country	:	US
Telephone Number	:	318-608-0273
Fax Number	:	318-608-0273

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JACQUELINE DANYAL RAMSEY
Credential	:	RAMSEY
Telephone Number	:	318-608-0273

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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