Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAKE B BLOOM, LPC
ActiveMental Health Counselor · MENOMONIE, WI
Registration Details
- NPI Number
- 1730712308
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 21, 2020 (6.1626233733056 yrs)
- Last Updated
- Dec 2, 2020
- License
-
4058-125 (WI)
Practice Information
- Address
-
4076 KOTHLOW AVEMENOMONIE, WI, 547513090Browse WI providers · Browse ZIP 54751
- Phone
- 7152354537
- Fax
- 7152354535
- Primary Specialty
-
Mental Health Counselor
101YM0800X
Other Mental Health Counselor Providers in MENOMONIE, WI
| Name | Credential | NPI |
|---|---|---|
| DIANE K. DELEGARD | PH.D. | 1093746729 |
| STEVEN R. SIEGLE | PSY.D. | 1700801925 |
| MS. CAROL SUE CHERNEY | MS CRC G&C | 1538253745 |
| MS. JENNY JOHANNA TIMM | MSE | 1245364587 |
| MR. CRAIG J GEISSLER | BS | 1578755625 |
| MR. JEFFREY PAUL IMLER | MSSW | 1598939696 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.