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Organization
NOVABLOOM CENTERS LLC
Active
Organization
NOVABLOOM CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RISHI PATEL (MANAGING MEMBER)
(214) 235-9716
Entity
Organization
Contact information
Practice address
807 CAMERON CT, COPPELL, TX 75019-4751
(214) 235-9716
Mailing address
807 CAMERON CT, COPPELL, TX 75019-4751
(214) 235-9716
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
NULL
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
NULL
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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