BLOOMINGTON NEUROFEEDBACK (NPI# 1710585997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710585997 |
| Entity Type | Organization |
| Organization Name | BLOOMINGTON NEUROFEEDBACK |
| Practice Address |
1905 S Liberty Dr Bloomington IN 47403-5146 |
| Practice Telephone | 8126686220 |
| Practice Fax Number | 8126686225 |
| Mailing Telephone | 8126886220 |
| Mailing Fax Number | 8126686225 |
| Enumeration Date | 2020-10-11 |
| Last Update Date | 2020-10-11 |
| Authorized Official Name | RHONDA SOUDER (OWNER) |
| Authorized Official Telephone | 5022320405 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
1905 S LIBERTY DR |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-5146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214159 | Amber Kinney, LLC | Clinic/Center | 623 S Washington St Apt A, Bloomington, IN 47401-5645 | 2020-10-28 |
| 1235744533 | Integrity Counseling, Inc. | Clinic/Center | 502 S Morris Ave Unit D, Bloomington, IL 61701-4891 | 2020-09-13 |
| 1326658568 | Jennifer Steinmetz Msw LLC | Clinic/Center | 115 N College Ave Ste 225, Bloomington, IN 47404-4099 | 2020-08-03 |
| 1376174904 | Karen Brosius LLC | Clinic/Center | 901 S Rogers St Ste 201, Bloomington, IN 47403-4760 | 2020-02-02 |
| 1023675634 | County of Mclean | Clinic/Center | 200 W Front St Ste 400e, Bloomington, IL 61701-5048 | 2019-05-20 |
| 1982175212 | Blue Skies Counseling LLC | Clinic/Center | 200 W Monroe St # 302a, Bloomington, IL 61701-3997 | 2018-12-16 |
| 1740705946 | Sea Glass Counseling, LLC | Clinic/Center | 2103 E Washington St Ste 2f, Bloomington, IL 61701-4365 | 2017-08-08 |
| 1164813671 | Inspiring Enterprises, LLC | Clinic/Center | 202 N Prospect Rd, Suite 207, Bloomington, IL 61704-7914 | 2015-02-05 |
| 1659761633 | Minnesota Counseling and Therapy Center | Clinic/Center | 140 W 98th St Ste 105, Bloomington, MN 55420-4800 | 2015-01-29 |
| 1962797449 | Kristin Lena Almquist | Clinic/Center | 1021 W 106th St, Bloomington, MN 55431-4150 | 2011-06-13 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
Please comment or provide details below to improve the information on BLOOMINGTON NEUROFEEDBACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.