Individual provider Active NPI

Lorraine Bloom, BCBA, LBA

  • Behavior Analyst
  • Portsmouth, VA
National Provider Identifier
1134553472
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133000240 Issued in VA
Practice address
67 Riverview Ave
Portsmouth, VA 23704-1928
Phone
(313) 675-0411
Fax
(866) 586-0747
NPI assigned
Aug 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0133000240 VA Primary

Addresses

Primary practice location

67 Riverview Ave
Portsmouth, VA 23704-1928

Mailing address

67 Riverview Ave
Portsmouth, VA 23704-1928
Phone (313) 675-0411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0133000240VAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1134553472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 RIVERVIEW AVE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237041928",
            "telephone_number": "313-675-0411",
            "fax_number": "866-586-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 RIVERVIEW AVE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237041928",
            "telephone_number": "313-675-0411",
            "fax_number": "866-586-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "LORRAINE",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-22",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.