# BLOOM BEHAVIORAL HEALTH & WELLNESS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083314629
- **Authorized official:** CHARLEDRIA MCGEE DNP, PMHNP (OWNER, PROVIDER)
- **Authorized official phone:** (901) 870-8624

## Contact information

- **Practice address:** 200 S RHODES ST STE E, WEST MEMPHIS, AR 72301-4213
- **Practice address phone:** (662) 912-6024
- **Practice address fax:** (662) 265-9483
- **Mailing address:** 2416 FALLINGWATER LN APT 102, CORDOVA, TN 38016-7686
- **Mailing address phone:** (901) 870-8624
- **Mailing address fax:** (662) 265-9483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2023
- **Last updated:** 03/02/2023