Organization · NPI-2
Desert Bloom Counseling, PLLC
Social Worker, Clinical · Bullhead City, AZ
NPI number1396452900
StatusActive
Last updated in NPPESFeb 14, 2023
Details
- NPI
- 1396452900
- Entity type
- Organization (NPI-2)
- Legal business name
- Desert Bloom Counseling, PLLC
- Organization subpart
- No
- Enumeration date
- Nov 2, 2022
- Certification date
- Feb 14, 2023
- Last updated
- Feb 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
| 106H00000X | Marriage & Family Therapist | – | – |
Practice location
2755 Silver Creek Rd Ste 203Bullhead City, AZ 86442-8347
Phone 928-299-2678 · Fax 928-350-6405
Mailing address
2755 Silver Creek Rd Ste 203Bullhead City, AZ 86442-8347
Phone 928-299-2678 · Fax 928-350-6405
Authorized official
Jennifer Staggs
Owner/Therapist
9282992678
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