Provider Demographics
NPI:1427768993
Name:BLOOMING ORCHIDS WELLNESS
Entity type:Organization
Organization Name:BLOOMING ORCHIDS WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-939-9271
Mailing Address - Street 1:1518 W WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-1424
Mailing Address - Country:US
Mailing Address - Phone:517-939-9270
Mailing Address - Fax:877-794-7416
Practice Address - Street 1:1518 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1424
Practice Address - Country:US
Practice Address - Phone:517-939-9271
Practice Address - Fax:877-794-7416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-24
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013491083OtherNPI
1023652880OtherNPI
MI1023652880Medicaid