MEDICARE: BLOOM AND BE WELL, 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1912839424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM AND BE WELL, PLLC

Provider Business Mailing Address
First Line	:	11639 S COPPER ROSE WAY
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-8189
Country	:	US
Telephone Number	:	435-215-6185
Fax Number	:

Provider Business Practice Location Address
First Line	:	11639 S COPPER ROSE WAY
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-8189
Country	:	US
Telephone Number	:	435-215-6185
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	SAMANTHA J SADLIER
Credential	:	LCSW
Telephone Number	:	435-215-6185

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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