# MIND BLOOM COUNSELING P.L.L.C.

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

## Provider details

- **NPI number:** 1255185658
- **Authorized official:** JILL BOLTJES MA, LPCC (OWNER)
- **Authorized official phone:** (507) 608-5979

## Contact information

- **Practice address:** 215 N CEDAR ST STE A, LUVERNE, MN 56156-1626
- **Practice address phone:** (507) 608-5979
- **Practice address fax:** (507) 607-8774
- **Mailing address:** 729 N CEDAR ST, LUVERNE, MN 56156-1318
- **Mailing address phone:** (507) 608-5979
- **Mailing address fax:** (507) 607-8774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2024
- **Last updated:** 04/15/2024