Blooming Agave Wellness LLC
Blooming Agave Wellness LLC is a healthcare organization registered as Adult Mental Health Clinic/Center in Phoenix, AZ, holding Type 2 (organization) NPI 1053144154 since 2024. The authorized official on file is Joshua Phillips, Therapist/Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1053144154 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Blooming Agave Wellness LLC |
| Practice address | 4117 N 17TH ST, Phoenix, AZ, 85016 |
| Phone | 6232392312 |
| Enumeration date | 2024-08-23 |
| Last updated in NPPES | 2024-08-23 |
Authorized official
| Name | Joshua Phillips |
|---|---|
| Title | Therapist/Owner |
| Phone | 9702608286 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QM0850X | Adult Mental Health Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Blooming Agave Wellness LLC NPI: 1053144154 Taxonomy: 261QM0850X (Adult Mental Health Clinic/Center) Address: 4117 N 17TH ST, Phoenix, AZ, 85016
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1396891271 | Kevin Flynn | Individual | Community/Behavioral Health Agency | Phoenix, AZ |
| 1962641787 | Emma Center Inc | Organization | Early Intervention Provider Agency | Phoenix, AZ |
| 1801266218 | Brian Kummet | Individual | Physician Assistant | Phoenix, AZ |
| 1285304584 | Joshua Phillips | Individual | Counselor | Phoenix, AZ |
| 1669113767 | Hannah Stonehill | Individual | Professional Counselor | Phoenix, AZ |
Verify this record
Cross-check NPI 1053144154 against the authoritative CMS record: view Blooming Agave Wellness LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Blooming Agave Wellness LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-08-23.