# ILYSE BLOOM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ilyse Bloom, LMFT, Ilyse Bloom
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053107359
- **Authorized official:** ILYSE BLOOM LMFT (OWNER)
- **Authorized official phone:** (303) 931-8492

## Contact information

- **Practice address:** 3100 ARAPAHOE AVE STE 101, BOULDER, CO 80303-1050
- **Practice address phone:** (303) 931-8492
- **Mailing address:** 4509 WELLINGTON RD, BOULDER, CO 80301-3155
- **Mailing address phone:** (303) 931-8492

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2025
- **Last updated:** 04/25/2025