MEDICARE: BLOOM AND GROW PSYCHOLOGICAL 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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1689506123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM AND GROW PSYCHOLOGICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	1311 COLUMBUS AVE
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44870-3569
Country	:	US
Telephone Number	:	419-357-4876
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 COLUMBUS AVE
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44870-3569
Country	:	US
Telephone Number	:	419-357-4876
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST AND OWNER
Name	:	DR. MEGHAN MURRAY
Credential	:	PHD
Telephone Number	:	419-357-4876

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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