NPI 1770853939 · live from the CMS NPI Registry
Bloom Behavior Therapy LLC
Community/Behavioral Health in Paducah, KY. National Provider Identifier 1770853939, active.
NPI record
| NPI | 1770853939 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Community/Behavioral Health 251S00000X |
| Practice location | 6201 Benton Rd, Paducah, KY 42003 |
| Practice phone | 270-908-0461 |
| Enumerated | January 5, 2012 |
| Last updated | July 8, 2021 |
| Authorized official | Becky Nastally, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | KY-0016 (KY) |
| Day Training, Developmentally Disabled Services | 251C00000X | — |
| Community/Behavioral Health primary | 251S00000X | 800217 (KY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.