Michael V Bloom PHD LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

MICHAEL V BLOOM PHD LLC

Practice address

7920 Kirkland CT
Portage, MI 49024-4974

Phone

(269) 345-0669

Fax

(269) 345-5354

NPI assigned

Sep 17, 2019

Last updated

Sep 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael V Bloom, PHDNPI 1477530392

Title

Psychologist

Phone

(269) 345-0669

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael V Bloom, PHD

  • Psychologist
  • Portage, MI
  • NPI 1477530392
  NPD Authorized official

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1073163580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3272",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486053272",
            "telephone_number": "989-797-1400",
            "fax_number": "989-797-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 KIRKLAND CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244974",
            "telephone_number": "269-345-0669",
            "fax_number": "269-345-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL V BLOOM PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "269-345-0669",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6301017079",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Meyer
• Denise Lynn Meyer, PHARMD
• Timothy Meyer, LMSW
• Kimberly Meyers, PT
• Sabbir Miah, RPH
• Michelle Hanson
• Michigan Integrated Therapies
• Michigan Integrated Therapies
• Michigan Senior Care Inc.
• Mid Michigan Home Visiting Doctors LLC

• Psychologist in Portage, MI
• Providers in Portage, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.