| Desert Bloom Counseling, Pllc | |
|
2755 Silver Creek Rd Ste 203 Bullhead City AZ 86442-8347 | |
| (928) 299-2678 | |
| (928) 350-6405 |
| Full Name | Desert Bloom Counseling, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2755 Silver Creek Rd Ste 203, Bullhead City, Arizona |
| Authorized Official Name and Position | Jennifer Staggs (OWNER/THERAPIST) |
| Authorized Official Contact | 9282992678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Bloom Counseling, Pllc 2755 Silver Creek Rd Ste 203 Bullhead City AZ 86442-8347 Ph: (928) 299-2678 | Desert Bloom Counseling, Pllc 2755 Silver Creek Rd Ste 203 Bullhead City AZ 86442-8347 Ph: (928) 299-2678 |
| NPI Number | 1396452900 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 02/14/2023 |
| Certification Date | 02/14/2023 |
| Medicare PECOS PAC ID | 8527424324 |
|---|---|
| Medicare Enrollment ID | O20230522001329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396452900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| Provider Name | Jennifer Staggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093179566 PECOS PAC ID: 9436515236 Enrollment ID: I20230522001378 |
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