Miriam Blum, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1167 Issued in CO

Practice address

3225 International Cir Ste 102
Colorado Springs, CO 80910-3161

Phone

(719) 471-1466

NPI assigned

Sep 9, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Life Enhancement Technologies, Inc.

  • Psychologist
  • Colorado Springs, CO
  • NPI 1144577099
  NPD (past) Authorized official

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1023844859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62595",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809622595",
            "telephone_number": "719-531-6078",
            "fax_number": "719-531-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 INTERNATIONAL CIR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103161",
            "telephone_number": "719-471-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "MIRIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "1167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluebell Vision PLLC
• Bluebird Mental Health & Wellness LLC
• Kimberly Bluejacket
• William Bluejacket
• Matthew Blum, MD
• Chelsea Leigh Blume
• Noami Blumenberg, PA-C
• Charles Blunt
• Scott Blystone
• Debra Lorraine Blythe, SLP

• Clinical Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.