William Bloom, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301006833 Issued in MI

Practice address

2855 Coolidge Highway
Suite 101
Troy, MI 48084

Phone

(248) 649-9202

Fax

(248) 649-8922

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Childrens Orthogenic Institute

  • Psychologist
  • Troy, MI
  • NPI 1770596587
  NPD (past) Authorized official
• Emotional Advantage LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ferndale, MI
  • NPI 1447647789
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083627947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 COOLIDGE HIGHWAY",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48084",
            "telephone_number": "248-649-9202",
            "fax_number": "248-649-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 COOLIDGE HIGHWAY",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48084",
            "telephone_number": "248-649-9202",
            "fax_number": "248-649-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301006833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "620F34877",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brett W. Blickenstaff, PA
• David Blinkhorn
• William Alexander Block, M.D.
• Rachel Amanda Bloecker, NP
• Brookelyn Blonquist
• Alexis Bloomberg
• Bloomfield Child & Family Counseling PLLC
• Kendra Blount, MS
• Blue Angel Home Care LLC
• Blue Home Health Care, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.