Provider Demographics
NPI:1235960253
Name:FROM ROOT TO BLOOM COUNSELING LLC
Entity type:Organization
Organization Name:FROM ROOT TO BLOOM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, NCC, PLPC
Authorized Official - Phone:636-312-8483
Mailing Address - Street 1:21 DEERPATH DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-4213
Mailing Address - Country:US
Mailing Address - Phone:636-312-8483
Mailing Address - Fax:
Practice Address - Street 1:14137 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-8355
Practice Address - Country:US
Practice Address - Phone:314-384-9904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty