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Organization

BLOOM COUNSELING AND ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JILL TALAVERA LCPC, CADC, PCGC (PARNTER)
(217) 971-3182
Entity
Organization

Contact information

Practice address
2609 MONTEGA DR STE B, SPRINGFIELD, IL 62704-7011
(217) 971-3182
Mailing address
2609 MONTEGA DR STE B, SPRINGFIELD, IL 62704-7011
(217) 971-3182

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1578876176
NPI
IL
Enumeration date
04/08/2026
Last updated
04/08/2026
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