FULL BLOOM THERAPY & CONSULTING NPI 1770049769

NPI Information

NPI: 1770049769
Provider Name: FULL BLOOM THERAPY & CONSULTING
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
9 BOWDOIN MILL IS
TOPSHAM, ME
ZIP 04086
Phone: (207) 837-6599
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FULL BLOOM THERAPY & CONSULTING is an adolescent and children mental health clinic center in Topsham, ME. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. FULL BLOOM THERAPY & CONSULTING NPI is 1770049769. The provider is registered as an organization entity type.

The provider's business location address is:

9 BOWDOIN MILL IS
TOPSHAM, ME
ZIP 04086-263
Phone: (207) 837-6599

The provider's authorized official is Stacey Michelle Jenkins .
The authorized official title is Owner and has the following contact phone number (207) 837-6599.

The enumeration date for this NPI number is 2/14/2019 and was last updated on 11/5/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1780018119	MEDICAID	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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