| Bloom Counseling Service | |
|
764 Frey Rd Chambersburg PA 17202-9662 | |
| (240) 602-6949 | |
| Not Available |
| Full Name | Bloom Counseling Service |
|---|---|
| Speciality | Counselor |
| Location | 764 Frey Rd, Chambersburg, Pennsylvania |
| Authorized Official Name and Position | Casandra Elaine Theriault (OWNER) |
| Authorized Official Contact | 2404698594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Counseling Service 764 Frey Rd Chambersburg PA 17202-9662 Ph: (240) 469-8594 | Bloom Counseling Service 764 Frey Rd Chambersburg PA 17202-9662 Ph: (240) 602-6949 |
| NPI Number | 1457033862 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 08/04/2023 |
| Certification Date | 08/04/2023 |
| Medicare PECOS PAC ID | 4082065263 |
|---|---|
| Medicare Enrollment ID | O20240111004952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457033862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Casandra Elaine Theriault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750897385 PECOS PAC ID: 3274984455 Enrollment ID: I20240111004937 |
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