NPIMap

Organization Active NPI

Blooming Minds Psychotherapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sheboygan, WI
National Provider Identifier
1780250035
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BLOOMING MINDS PSYCHOTHERAPY LLC
Practice address
601 N 5TH St Ste 9
Sheboygan, WI 53081-4623
Phone
(920) 977-3111
Fax
(920) 482-5662
NPI assigned
May 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mindy Kue, LPCNPI 1952937351
Title
Owner
Phone
(920) 977-3111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

601 N 5TH St Ste 9
Sheboygan, WI 53081-4623

Mailing address

1432 N 10TH St
Sheboygan, WI 53081-3332
Phone (920) 912-8628

Other identifiers 1

IdentifierTypeStateIssuer
1780250035MedicaidWI

Other names 1

  • Mindy Kue LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

601 N 5th St
Ste 9
Sheboygan, WI 53081
Phone (920) 977-1111

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1780250035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 N 10TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813332",
            "telephone_number": "920-912-8628",
            "fax_number": "920-482-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 5TH ST STE 9",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814623",
            "telephone_number": "920-977-3111",
            "fax_number": "920-482-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING MINDS PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "KUE",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-977-3111",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780250035",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindy Kue LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.