Blooming Pathways Therapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLOOMING PATHWAYS THERAPY LLC

Practice address

245 Regency CT Ste 200
Brookfield, WI 53045-6167

Phone

(262) 955-7786

NPI assigned

Oct 23, 2024

Last updated

Oct 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Lee Manganello, LCSWNPI 1124749809

Title

Psychotherapist, Owner

Phone

(262) 955-7786

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa Manganello, LCSW

  • Clinical Social Worker
  • Waukesha, WI
  • NPI 1124749809
  NPD Authorized official

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1831910637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W292S2954 ANCESTRAL DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531889203",
            "telephone_number": "262-955-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 REGENCY CT STE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456167",
            "telephone_number": "262-955-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING PATHWAYS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "MANGANELLO",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST, OWNER",
        "authorized_official_telephone_number": "262-955-7786",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryanne Lee Blanton, BCBA, LBA, MS
• Gregory Michael Blau, D.C.
• Dean Thomas Blazek, D.C.
• Madeline Bliske, PHD
• Blooming Buds Medicine
• Tiana Blue
• Bluemound Health Services SC
• Bluemound Orthopaedic Group, LTD
• Daniel Peter Bock, DPT
• Bodygenic Physical Therapy LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.