Healthcare Provider Details

I. General information

NPI: 1205757663
Provider Name (Legal Business Name): BLOOMING MINDS COUNSELING CTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23622 CALABASAS RD STE 115
CALABASAS CA
91302-1576
US

IV. Provider business mailing address

4510 WILLENS AVE
WOODLAND HILLS CA
91364-3807
US

V. Phone/Fax

Practice location:
  • Phone: 805-864-1275
  • Fax:
Mailing address:
  • Phone: 805-864-1275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MERSEDEH MARY KAVIANY
Title or Position: OWNER
Credential:
Phone: 310-961-2755