Provider Demographics
NPI:1225881949
Name:HEAL & BLOOM THERAPY LLC
Entity Type:Organization
Organization Name:HEAL & BLOOM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-719-8899
Mailing Address - Street 1:5487 MAPLE RDG
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8651
Mailing Address - Country:US
Mailing Address - Phone:517-719-8899
Mailing Address - Fax:
Practice Address - Street 1:4265 OKEMOS RD STE C
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3285
Practice Address - Country:US
Practice Address - Phone:517-212-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)