Healthcare Provider Details

I. General information

NPI: 1467376426
Provider Name (Legal Business Name): BLOOMGARDEN MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11031 SHERIDAN BLVD STE 200
WESTMINSTER CO
80020-3437
US

IV. Provider business mailing address

11031 SHERIDAN BLVD STE 200
WESTMINSTER CO
80020-3437
US

V. Phone/Fax

Practice location:
  • Phone: 720-583-4777
  • Fax:
Mailing address:
  • Phone: 720-583-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL M GOWDY
Title or Position: OWNER
Credential: LCSW, LAC
Phone: 720-583-4777