Provider Demographics
NPI:1205556834
Name:BLOOM & THRIVE LLC
Entity type:Organization
Organization Name:BLOOM & THRIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELP
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:610-708-1289
Mailing Address - Street 1:1413 RUTLAND DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-6208
Mailing Address - Country:US
Mailing Address - Phone:610-708-1289
Mailing Address - Fax:
Practice Address - Street 1:1413 RUTLAND DR UNIT B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-6208
Practice Address - Country:US
Practice Address - Phone:610-708-1289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty