MEDICARE: BLOOMING COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1053267443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMING COUNSELING LLC

Provider Business Mailing Address
First Line	:	11010 GOLDENROD FERN DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-2228
Country	:	US
Telephone Number	:	656-266-2195
Fax Number	:

Provider Business Practice Location Address
First Line	:	11010 GOLDENROD FERN DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-2228
Country	:	US
Telephone Number	:	656-266-2195
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROSA VIRGINIA SALON GARCIA
Credential	:	LMHC
Telephone Number	:	656-266-2195

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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