Organization
BLOOM WOMEN'S COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE NELSON-GERHARDT M.S., LMFT (OWNER/MANAGER)
(815) 508-6936
Entity
Organization
Contact information
Practice address
122 S LOCUST ST, SUITE 5, SYCAMORE, IL 60178-1865
(815) 508-6936
(815) 599-1380
Mailing address
122 S LOCUST ST, SUITE 5, SYCAMORE, IL 60178-1865
(815) 508-6936
(815) 599-1380
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.000746
IL
Other
Enumeration date
03/21/2016
Last updated
03/21/2016
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