Provider Demographics
NPI:1497479315
Name:BLOOM THERAPY LLC
Entity Type:Organization
Organization Name:BLOOM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALINIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-836-0844
Mailing Address - Street 1:2036 DELANO DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1237
Mailing Address - Country:US
Mailing Address - Phone:404-836-0844
Mailing Address - Fax:
Practice Address - Street 1:1259 MONROE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3439
Practice Address - Country:US
Practice Address - Phone:404-836-0844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty