Provider Demographics
NPI:1699552596
Name:BLOOM COUNSELING
Entity type:Organization
Organization Name:BLOOM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-282-2168
Mailing Address - Street 1:37614 HUGHESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-4128
Mailing Address - Country:US
Mailing Address - Phone:703-282-2168
Mailing Address - Fax:
Practice Address - Street 1:222 CATOCTIN CIR SE STE 217
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3730
Practice Address - Country:US
Practice Address - Phone:703-831-5142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)