| Bloom Mental Health And Wellness Llc | |
|
1207 S Main St Ste 1 Palmer MA 01069-1897 | |
| (413) 200-2808 | |
| (223) 924-9926 |
| Full Name | Bloom Mental Health And Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1207 S Main St Ste 1, Palmer, Massachusetts |
| Authorized Official Name and Position | Shaina Rae Labonte (OWNER) |
| Authorized Official Contact | 4132002808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Mental Health And Wellness Llc 1207 S Main St Ste 1 Palmer MA 01069-1897 Ph: (413) 200-2808 | Bloom Mental Health And Wellness Llc 1207 S Main St Ste 1 Palmer MA 01069-1897 Ph: (413) 200-2808 |
| NPI Number | 1255188462 |
|---|---|
| Provider Enumeration Date | 05/04/2024 |
| Last Update Date | 04/15/2026 |
| Certification Date | 04/15/2026 |
| Medicare PECOS PAC ID | 5395281349 |
|---|---|
| Medicare Enrollment ID | O20240725003693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255188462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Shaina Labonte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972050318 PECOS PAC ID: 1456630300 Enrollment ID: I20161116001455 |
Baystate Wing Hospital Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Wright St, Palmer, MA 01069 Phone: 413-283-7651 Fax: 413-284-5117 |