| Bloom Counseling Llc | |
|
510 Hartbrook Dr Ste 201 Hartland WI 53029-1444 | |
| (262) 528-2015 | |
| (866) 284-8107 |
| Full Name | Bloom Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 510 Hartbrook Dr Ste 201, Hartland, Wisconsin |
| Authorized Official Name and Position | E Lee Garza (PARTNER COUNSELOR) |
| Authorized Official Contact | 2625282015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Counseling Llc 510 Hartbrook Dr Ste 201 Hartland WI 53029-1444 Ph: (262) 528-2015 | Bloom Counseling Llc 510 Hartbrook Dr Ste 201 Hartland WI 53029-1444 Ph: (262) 528-2015 |
| NPI Number | 1528442464 |
|---|---|
| Provider Enumeration Date | 07/09/2015 |
| Last Update Date | 07/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528442464 | NPI | - | NPPES |
| 100042870 | Medicaid | WI | |
| 100045001 | Medicaid | WI | |
| 100027690 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5606-125 (Wisconsin) | Primary |
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