# INNERBLOOM THERAPY LLC

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

## Provider details

- **NPI number:** 1649108226
- **Authorized official:** CONNIE POWELL (LCSW)
- **Authorized official phone:** (385) 558-8466

## Contact information

- **Practice address:** 1412 S LEGEND HILLS DR STE 327, CLEARFIELD, UT 84015-1592
- **Practice address phone:** (385) 558-8466
- **Mailing address:** 819 S 2200 W, SYRACUSE, UT 84075-7187
- **Mailing address phone:** (385) 558-8466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2026
- **Last updated:** 05/12/2026