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Contact Information

BRIGHT BLOOM THERAPY
1560 E. SOUTHLAKE BLVD.
STE. 100
SOUTHLAKE, TX76092
 Phone: 818-235-2119
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Marriage & Family Therapist

106H00000X
 

Mental Health

101YM0800X
 

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for BRIGHT BLOOM THERAPY

NPI Number 1386521235
LBN Legal business name BRIGHT BLOOM THERAPY
Authorized official DANIELLE WIGFALL - (MENTAL HEALTH THERAPIST)
Entity Organization
Organization subpart 1 No
Enumeration date 08/20/2025
Last updated 09/23/2025 - About 8 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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