MEDICARE: BLOOMING MINDS THERAPY

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1346103819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMING MINDS THERAPY

Provider Business Mailing Address
First Line	:	7905 BIG BEND BLVD STE 200
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-2715
Country	:	US
Telephone Number	:	314-200-5881
Fax Number	:

Provider Business Practice Location Address
First Line	:	7905 BIG BEND BLVD STE 200
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-2715
Country	:	US
Telephone Number	:	314-200-5881
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LEAH ERICKSON
Credential	:	LCSW
Telephone Number	:	618-363-7230

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “BLOOMING MINDS THERAPY ” Practice Location

Language	Start Address	Practice Location

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