Healthcare Provider Details

I. General information

NPI: 1144811852
Provider Name (Legal Business Name): BLOSSOMING MINDS HEALTH CENTER AND FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 STUMPF BLVD STE B7-7
TERRYTOWN LA
70056-3949
US

IV. Provider business mailing address

1799 STUMPF BLVD STE B7-7
TERRYTOWN LA
70056-3949
US

V. Phone/Fax

Practice location:
  • Phone: 504-233-2288
  • Fax: 844-870-0727
Mailing address:
  • Phone: 504-233-2288
  • Fax: 844-870-0727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EBONY EVANS
Title or Position: OWNER
Credential: LPC-S
Phone: 504-233-2288