Provider Demographics
NPI:1447122049
Name:THERABLOOM FAMILY COUNSELING INC
Entity type:Organization
Organization Name:THERABLOOM FAMILY COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PSY, LMFT
Authorized Official - Phone:310-957-5091
Mailing Address - Street 1:10000 WASHINGTON BLVD FL 6
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2781
Mailing Address - Country:US
Mailing Address - Phone:310-957-5091
Mailing Address - Fax:310-957-5092
Practice Address - Street 1:10000 WASHINGTON BLVD FL 6
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2781
Practice Address - Country:US
Practice Address - Phone:310-957-5091
Practice Address - Fax:310-957-5092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty