Provider Demographics
NPI:1144011255
Name:BLOOM INTO YOU COUNSELING LLC
Entity type:Organization
Organization Name:BLOOM INTO YOU COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-373-4042
Mailing Address - Street 1:88 PAINE CIR STE 6
Mailing Address - Street 2:
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1449
Mailing Address - Country:US
Mailing Address - Phone:515-373-4042
Mailing Address - Fax:515-685-6449
Practice Address - Street 1:88 PAINE CIR STE 6
Practice Address - Street 2:
Practice Address - City:BONDURANT
Practice Address - State:IA
Practice Address - Zip Code:50035-1449
Practice Address - Country:US
Practice Address - Phone:515-373-4042
Practice Address - Fax:515-685-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty