| In Bloom Mental Health Counseling, Llc | |
|
247 Prospect Ave Ste 4h Brooklyn NY 11215-8403 | |
| (347) 509-7127 | |
| Not Available |
| Full Name | In Bloom Mental Health Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 247 Prospect Ave Ste 4h, Brooklyn, New York |
| Authorized Official Name and Position | Shandelle Hether-gray (OWNER) |
| Authorized Official Contact | 3475097127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| In Bloom Mental Health Counseling, Llc 2324 W Joppa Rd Ste 410 Lutherville MD 21093-4620 Ph: (443) 446-4718 | In Bloom Mental Health Counseling, Llc 247 Prospect Ave Ste 4h Brooklyn NY 11215-8403 Ph: (347) 509-7127 |
| NPI Number | 1215547831 |
|---|---|
| Provider Enumeration Date | 08/07/2020 |
| Last Update Date | 08/12/2022 |
| Certification Date | 08/12/2022 |
| Medicare PECOS PAC ID | 8426496886 |
|---|---|
| Medicare Enrollment ID | O20240403003948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215547831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Eugene A Pometto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104115336 PECOS PAC ID: 1557700671 Enrollment ID: I20240430001258 |
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