Bloom Behavioral Health Partners PLLC
Counselor, Mental Health in Grand Rapids, MI. Organization (NPI-2).
NPI number1174176366
StatusActive
Last updated in NPPESFeb 25, 2022
Details
- NPI
- 1174176366
- Entity type
- Organization (NPI-2)
- Legal business name
- Bloom Behavioral Health Partners PLLC
- Organization subpart
- No
- Enumeration date
- Jul 17, 2019
- Certification date
- Feb 25, 2022
- Last updated
- Feb 25, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 103TC1900X | Psychologist, Counseling | – | – | |
| 104100000X | Social Worker | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – |
Practice location
1514 Wealthy St Se Ste 242Grand Rapids, MI 49506-2755
Phone 616-202-2138 · Fax 616-228-8990
Mailing address
1514 Wealthy St Se Ste 242Grand Rapids, MI 49506-2755
Phone 616-202-2138 · Fax 616-228-8990
Other practice locations
333 W Western Ave Ste 5
Muskegon, MI 49440-1266
Muskegon, MI 49440-1266
Phone 616-202-2138
509 Franklin Ave
Grand Haven, MI 49417-1400
Grand Haven, MI 49417-1400
Phone 616-202-2189 · Fax 616-228-8990
Authorized official
Matthew Thatcher
Owner / Counselor
6162022138
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