Provider Demographics
NPI:1356233670
Name:COCOON AND BLOOM COLLECTIVE LLC
Entity type:Organization
Organization Name:COCOON AND BLOOM COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEATING
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:440-305-0556
Mailing Address - Street 1:976 JONATHAN ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-3131
Mailing Address - Country:US
Mailing Address - Phone:440-305-0556
Mailing Address - Fax:
Practice Address - Street 1:976 JONATHAN ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-3131
Practice Address - Country:US
Practice Address - Phone:440-305-0556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty