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General NPI Number Information
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NPI Number | 1851247167
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Entity Type | Organization
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Legal Business Name | BLOOMING MINDS COUNSELING PLLC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 3767 E US ROUTE 36
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City | DECATUR
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State | IL
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Zip | 62521-5085
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Country | US
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Telephone | 217-521-4037
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25
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City | MT ZION
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State | IL
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Zip | 62549-0025
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Country | US
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Telephone | 217-521-4037
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Fax |
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Authorized Official
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Title or Position | LCSW/PWNER
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Name | AMANDA FISHER
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Credential | LCSW
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Telephone | 217-521-4037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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