Provider Demographics
NPI:1992483077
Name:BLOOM BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:BLOOM BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-419-2741
Mailing Address - Street 1:45 LAFAYETTE RD # 326
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2451
Mailing Address - Country:US
Mailing Address - Phone:978-419-2741
Mailing Address - Fax:
Practice Address - Street 1:5 STERLING HILL LN APT 538
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4902
Practice Address - Country:US
Practice Address - Phone:978-419-2741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty