Healthcare Provider Details

I. General information

NPI: 1205751393
Provider Name (Legal Business Name): BLOOMING WITH HOPE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 COURTLAND ST STE 201
ORLANDO FL
32804-1343
US

IV. Provider business mailing address

604 COURTLAND ST STE 201
ORLANDO FL
32804-1343
US

V. Phone/Fax

Practice location:
  • Phone: 321-617-1146
  • Fax:
Mailing address:
  • Phone: 321-617-1146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MONICA SUSAN CAMACHO
Title or Position: PROVIDER/OWNER
Credential: RMHCI
Phone: 321-617-1146