Bloomster, Brent

Bloomster, Brent is an individual health care provider with primary practice located at 6503 E Broad St , Columbus OH 43213-1692. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Bloomster, Brent can be contacted via phone (614) 355-8160.

Contact Information

Primary practice address
6503 E Broad St Columbus OH 43213-1692
Phone: (614) 355-8160
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X E0001739-SUPV Ohio
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 5599 Ohio

Profile Details

NPI number 1396919437
LBN Legal business name Bloomster, Brent
Credentials PCC, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2008
Last updated May 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396919437 NPPES
Ohio MEDICAID 0210420
Ohio MEDICAID 2846675

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