# BLOOM THERAPEUTICS, LLC

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

## Provider details

- **NPI number:** 1629570056
- **Authorized official:** MRS. CONNIE JONES LCPC (THERAPIST/OWNER)
- **Authorized official phone:** (240) 758-2142

## Contact information

- **Practice address:** 7303 HANOVER PKWY STE C, GREENBELT, MD 20770-2029
- **Practice address phone:** (240) 758-2142
- **Practice address fax:** (301) 441-2511
- **Mailing address:** 7303 HANOVER PKWY STE C, GREENBELT, MD 20770-2029
- **Mailing address phone:** (240) 758-2142
- **Mailing address fax:** (240) 668-3690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LC6689 | MD | Yes |

## Other

- **Enumeration date:** 03/01/2018
- **Last updated:** 02/03/2022