MEDICARE: BLOOMING ACADEMIES FOUNDATION

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	:	1437096831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMING ACADEMIES FOUNDATION

Provider Business Mailing Address
First Line	:	125 S STATE ROAD 7 STE 104337
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4385
Country	:	US
Telephone Number	:	728-231-2718
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 S STATE ROAD 7 STE 104337
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4385
Country	:	US
Telephone Number	:	728-231-2718
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CLINICAL SERVICES
Name	:	MISS DANIELLE GARY
Credential	:	MA, MHC-LP
Telephone Number	:	728-231-2718

Provider Enumeration Date	:	05/02/2026
Last Update Date	:	05/02/2026

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Directions to “BLOOMING ACADEMIES FOUNDATION ” Practice Location

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