Joan G Bloomberg, LCSW
Individual provider Active NPI Clinical Social Worker · Old Chatham, NY
NPI 1083785265 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1083785265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- RO27641-1 (NY)
- Practice address
- 979 Highland Rd
Old Chatham, NY 12136-3407 - Phone
- (518) 794-8117
- Fax
- (518) 794-8107
- NPI assigned
- Nov 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RO27641-1 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | RO27641-1 | NY | Yes |
Addresses
Primary practice location
979 Highland Rd
Old Chatham, NY 12136-3407
Mailing address
979 Highland Rd
Old Chatham, NY 12136-3407
Phone (518) 794-8117
Other providers in Old Chatham, NY
All providers in Old Chatham, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.