Healthcare Provider Details

I. General information

NPI: 1427768993
Provider Name (Legal Business Name): BLOOMING ORCHIDS WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2022
Last Update Date: 12/18/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 W WILLOW ST
LANSING MI
48915-1424
US

IV. Provider business mailing address

1518 W WILLOW ST
LANSING MI
48915-1424
US

V. Phone/Fax

Practice location:
  • Phone: 517-939-9271
  • Fax: 877-794-7416
Mailing address:
  • Phone: 517-939-9270
  • Fax: 877-794-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ERICKA BARBER
Title or Position: OWNER/PROVIDER
Credential: LMSW
Phone: 517-939-9271