Organization
INTERNALLY BLOOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA SISCO LPC (OWNER/MANAGER/PROVIDER)
(479) 888-8234
Entity
Organization
Contact information
Practice address
5004 S U ST STE 200, FORT SMITH, AR 72903-3600
(479) 888-8234
(479) 888-8234
Mailing address
5004 S U ST STE 200, FORT SMITH, AR 72903-3600
(479) 888-8234
(479) 888-8234
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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