Provider Demographics
NPI:1134916109
Name:BLOOM AND THRIVE COUNSELING AND WELLNESS SERVICES LLC
Entity type:Organization
Organization Name:BLOOM AND THRIVE COUNSELING AND WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-453-4725
Mailing Address - Street 1:9 MILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6507
Mailing Address - Country:US
Mailing Address - Phone:609-453-4725
Mailing Address - Fax:
Practice Address - Street 1:9 MILLARD AVE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-6507
Practice Address - Country:US
Practice Address - Phone:609-453-4725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health