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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

PHOENIX BLOOM THERAPEUTICS, LLC
NPI 1700797370
Marriage & Family Therapist in Covington, KY

Active since September 14, 2026
31 HIDEAWAY DR, COVINGTON, KY 41017(859) 307-4540 Get Directions Write a Review

NPPES record added: September 14, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Phoenix Bloom Therapeutics, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHOENIX BLOOM THERAPEUTICS, LLC (NPI 1700797370) is a healthcare organization registered as a marriage & family therapist in Covington, Kentucky and active in the NPI registry since September 2026. The organization lists Tina Nichole Hacker, Owner, as its authorized official.

NPPES Registry Identity

NPI1700797370
Entity TypeOrganization
Primary Taxonomy106H00000X
Legal Business NamePHOENIX BLOOM THERAPEUTICS, LLC
Location Address31 HIDEAWAY DRCovington, KY 41017-9775
Mailing Address31 Hideaway DrCovington, KY 41017-9775 · (859) 307-4540
Phone(859) 307-4540
Organization SubpartNo
Authorized OfficialTina Nichole HackerOwner · (859) 307-4540
Enumeration DateSeptember 14, 2026
NPPES CertifiedSeptember 14, 2026
✔ NPI 1700797370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
31 HIDEAWAY DR, Covington, KY 41017
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHOENIX BLOOM FAMILY FOUNDATION, INC.
Marriage & Family Therapist
31 HIDEAWAY DR
COVINGTON, KY 41017
Kenton County (859) 307-4540
MS. TINA HACKER IMFT, LMFT, LICDC,
Marriage & Family Therapist
31 HIDEAWAY DR
COVINGTON, KY 41017
Kenton County (859) 307-4540

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phoenix Bloom Therapeutics, LLC's NPI number?

The NPI number for Phoenix Bloom Therapeutics, LLC is 1700797370. It was assigned to this organization in the NPPES registry on September 14, 2026.

Where is Phoenix Bloom Therapeutics, LLC located?

Phoenix Bloom Therapeutics, LLC is located at 31 Hideaway Dr, Covington, KY 41017. The listed phone number is (859) 307-4540.

What is Phoenix Bloom Therapeutics, LLC's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

When was this NPI record last updated?

The NPPES record for Phoenix Bloom Therapeutics, LLC was last updated on September 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.