| Bloom Mindfully Counseling Pllc | |
|
1212 Boston Tpke Ste B Bolton CT 06043-7451 | |
| (860) 246-6284 | |
| Not Available |
| Full Name | Bloom Mindfully Counseling Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1212 Boston Tpke Ste B, Bolton, Connecticut |
| Authorized Official Name and Position | Mackenzie Phelps (OWNER/CLINICIAN) |
| Authorized Official Contact | 8602466284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Mindfully Counseling Pllc 86 Buff Cap Rd Apt E4 Tolland CT 06084-2643 Ph: (860) 248-6284 | Bloom Mindfully Counseling Pllc 1212 Boston Tpke Ste B Bolton CT 06043-7451 Ph: (860) 246-6284 |
| NPI Number | 1376349043 |
|---|---|
| Provider Enumeration Date | 02/21/2025 |
| Last Update Date | 04/01/2025 |
| Certification Date | 04/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376349043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |