Healthcare Provider Details

I. General information

NPI: 1295367092
Provider Name (Legal Business Name): BLOOMING MINDS PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 N CORPORATE LAKES BLVD STE 206
WESTON FL
33326-3269
US

IV. Provider business mailing address

1820 N CORPORATE LAKES BLVD STE 206
WESTON FL
33326-3269
US

V. Phone/Fax

Practice location:
  • Phone: 786-505-3765
  • Fax: 786-765-0331
Mailing address:
  • Phone: 786-505-3765
  • Fax: 786-765-0331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NATALIE GIRALDO BARRIOS
Title or Position: CEO/ PSYCHOLOGIST
Credential: PSY.D.
Phone: 786-505-3765