Blooming Mind Pllc

LBN: Blooming Mind Pllc
Blooming Mind Pllc is an health care organization with primary practice located at 715 W Main St Ste L , Jenks OK 74037-3553. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Blooming Mind Pllc can be contacted via phone (918) 280-9166, or through Woltjer, Ashley via phone (918) 280-9166.

Contact Information

Primary practice address
715 W Main St Ste L Jenks OK 74037-3553
Phone: (918) 280-9166
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Woltjer, Ashley MS, LPC, NCC
Phone: (918) 280-9166

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1376253682
LBN Legal business name Blooming Mind Pllc
DBA Doing business as
Authorized official Woltjer, Ashley MS, LPC, NCC
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2022
Last updated Nov 28th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376253682 NPPES
Oklahoma MEDICAID 200892560A

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