Organization
BRIGHT BLOOM THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE WIGFALL LCSW (MENTAL HEALTH THERAPIST)
(818) 235-2119
Entity
Organization
Contact information
Practice address
1560 E. SOUTHLAKE BLVD., STE. 100, SOUTHLAKE, TX 76092
(818) 235-2119
Mailing address
1560 E SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-6462
(214) 509-7047
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/20/2025
Last updated
09/23/2025
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