MEDICARE: MS. JUDI E BLOOM LPC

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	101YM0800X	Mental Health Counselor	14561	TX
2	106H00000X	Marriage & Family Therapist	14531	TX

General Provider Information

NPI Number	:	1962497750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDI E BLOOM LPC

Provider Business Mailing Address
First Line	:	11500 NORTHWEST FWY
Second Line	:	STE 235
City	:	HOUSTON
State	:	TX
Zip	:	77092-6530
Country	:	US
Telephone Number	:	713-956-8194
Fax Number	:	713-683-1684

Provider Business Practice Location Address
First Line	:	11500 NORTHWEST FWY
Second Line	:	STE 235
City	:	HOUSTON
State	:	TX
Zip	:	77092-6530
Country	:	US
Telephone Number	:	713-956-8194
Fax Number	:	713-683-1684

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	09/11/2025

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Directions to “ MS. JUDI E BLOOM LPC” Practice Location

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