person
Jake B Bloom, LPC
Mental Health Counselor in Menomonie, Wisconsin
NPI 1730712308

Jake B Bloom is a Mental Health Counselor based in Menomonie, WI and is specialized in Mental Health. Jake B Bloom practices in Menomonie, WI and has the professional credentials of LPC. The NPI Number for Jake B Bloom is 1730712308 and holds a License No. 4058-125 (Wisconsin).

The current practice location address for Jake B Bloom is 4076 Kothlow Ave, Menomonie, WI and can be reached out via phone at 715-235-4537 and via fax at 715-235-4535.

Location: 4076 Kothlow Ave, Menomonie, WI, 54751-3740
person
Provider Profile Details
NPI Number
1730712308
Provider Name
Jake B Bloom
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
4076 Kothlow Ave, Menomonie, WI, 54751-3740
Phone Number
715-235-4537
Fax Number
715-235-4535
Provider Enumeration Date
02/21/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4076 Kothlow Ave
City
State
Zip
54751-3090
Phone Number
715-235-4537
Fax Number
715-235-4535
person
Provider Business Mailing Address Details
Address
4076 Kothlow Ave
City
State
Zip
54751-3090
Phone Number
715-235-4537
Fax Number
715-235-4535
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
4058-125 (Wisconsin)
Definition
Definition to come...
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