Charmonix Bloom Gilbert, SUDP-T

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61493843 Issued in WA

Practice address

4305 E Trent Ave
Spokane, WA 99212-1315

Phone

(509) 795-3133

NPI assigned

Feb 2, 2024

Sex

Female

Sole proprietor

No

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

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.

• WCHS, Inc

  • Methadone Clinic
  • Bellingham, WA
  • NPI 1811592116
  NPD (past)

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1053174995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 E TRENT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992121315",
            "telephone_number": "509-795-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 E TRENT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992121315",
            "telephone_number": "509-795-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM GILBERT",
        "first_name": "CHARMONIX",
        "credential": "SUDP-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61493843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blevins Family Medicine
• Blink Eyecare, PLLC
• Lisa Bliss, M.D.
• Patricia Jill Bliss
• Blissful Massage
• Andrea Bloom, LMHC, LMFT
• Andrew Allyn Bloom, PA-C
• Myron E Bloom, MD
• Amelia Kaye Bloomquist, APRN
• Jennah Kay Marie Blossom, MC61053752

• Addiction (Substance Use Disorder) Counselor in Spokane, WA
• Providers in Spokane, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.