MEDICARE: BLOOMING BUTTERFLIES THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TB0200X	Cognitive & Behavioral Psychologist
2	1041C0700X	Clinical Social Worker
3	106E00000X	Assistant Behavior Analyst
4	106S00000X	Behavior Technician
5	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1265378038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMING BUTTERFLIES THERAPY LLC

Provider Business Mailing Address
First Line	:	2655 S RAINBOW BLVD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2655 S RAINBOW BLVD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5100
Country	:	US
Telephone Number	:	702-726-9722
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ANN UGANIZA
Credential	:
Telephone Number	:	702-726-9722

Provider Enumeration Date	:	04/24/2026
Last Update Date	:	04/24/2026

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