Provider Demographics
NPI:1093392698
Name:BLOOM. CREATIVE ARTS THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:BLOOM. CREATIVE ARTS THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGONES
Authorized Official - Suffix:
Authorized Official - Credentials:MPS, LCAT LPC ATR-BC
Authorized Official - Phone:914-487-9600
Mailing Address - Street 1:827 ROUTE 82 STE 10-259
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-7351
Mailing Address - Country:US
Mailing Address - Phone:914-487-9600
Mailing Address - Fax:
Practice Address - Street 1:827 ROUTE 82 STE 10-259
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-7351
Practice Address - Country:US
Practice Address - Phone:914-487-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-28
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty