=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437096831
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLOOMING ACADEMIES FOUNDATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2026
-----------------------------------------------------
Last Update Date | 05/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 125 S STATE ROAD 7 STE 104337
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-4385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 728-231-2718
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 125 S STATE ROAD 7 STE 104337
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-4385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 728-231-2718
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF CLINICAL SERVICES
-----------------------------------------------------
Name | MISS DANIELLE GARY
-----------------------------------------------------
Credential | MA, MHC-LP
-----------------------------------------------------
Telephone | 728-231-2718
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------