Provider Demographics
NPI:1659088425
Name:BLOOMING MINDS, INC
Entity type:Organization
Organization Name:BLOOMING MINDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDOURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-667-2166
Mailing Address - Street 1:11856 BALBOA BLVD # 442
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-2753
Mailing Address - Country:US
Mailing Address - Phone:310-667-2166
Mailing Address - Fax:818-471-4111
Practice Address - Street 1:14668 WALNUT RD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-3983
Practice Address - Country:US
Practice Address - Phone:310-667-2166
Practice Address - Fax:818-471-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty