Provider Demographics
NPI:1235029117
Name:CLEMATIS BLOOM THERAPY LLC
Entity type:Organization
Organization Name:CLEMATIS BLOOM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MCLAMB
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:269-220-2715
Mailing Address - Street 1:101 W KIRKWOOD AVE STE 232
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-6134
Mailing Address - Country:US
Mailing Address - Phone:812-821-3337
Mailing Address - Fax:812-214-1519
Practice Address - Street 1:101 W KIRKWOOD AVE STE 232
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-6134
Practice Address - Country:US
Practice Address - Phone:812-821-3337
Practice Address - Fax:812-214-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty