| Integral Bloom, Inc. | |
|
100 Summer St Ste 1600 Boston MA 02110-2104 | |
| (857) 231-0376 | |
| (617) 412-3135 |
| Full Name | Integral Bloom, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 100 Summer St Ste 1600, Boston, Massachusetts |
| Authorized Official Name and Position | Maria Camille Mellano (OWNER, PRESIDENT) |
| Authorized Official Contact | 6179133898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integral Bloom, Inc. 525 Common St # H101 Belmont MA 02478-4454 Ph: (617) 913-3898 | Integral Bloom, Inc. 100 Summer St Ste 1600 Boston MA 02110-2104 Ph: (857) 231-0376 |
| NPI Number | 1265820070 |
|---|---|
| Provider Enumeration Date | 12/31/2014 |
| Last Update Date | 09/29/2023 |
| Certification Date | 09/29/2023 |
| Medicare PECOS PAC ID | 4082929021 |
|---|---|
| Medicare Enrollment ID | O20150819008424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265820070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 111055 (Massachusetts) | Primary |
| Provider Name | Maria C Mellano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578772588 PECOS PAC ID: 1355408782 Enrollment ID: I20090330000191 |
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