Healthcare Provider Details

I. General information

NPI: 1649115742
Provider Name (Legal Business Name): BLOOMING FUTURE BEHAVIORAL HEALTH AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8320 OLD COURTHOUSE RD STE 500
VIENNA VA
22182-3869
US

IV. Provider business mailing address

8320 OLD COURTHOUSE RD STE 500
VIENNA VA
22182-3869
US

V. Phone/Fax

Practice location:
  • Phone: 703-829-6976
  • Fax:
Mailing address:
  • Phone: 703-829-6976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: LAUREN HAMILTON BUELL
Title or Position: MANAGING MEMBER
Credential:
Phone: 703-829-6976