Provider Demographics
NPI:1801695879
Name:WILDBLOOM COUNSELING
Entity type:Organization
Organization Name:WILDBLOOM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:484-258-4865
Mailing Address - Street 1:7 WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-9307
Mailing Address - Country:US
Mailing Address - Phone:484-258-4865
Mailing Address - Fax:
Practice Address - Street 1:7 WEAVER RD
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-9307
Practice Address - Country:US
Practice Address - Phone:484-258-4865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty