Active NPI
Lorraine Bloom, BCBA, LBA
- Behavior Analyst
- Portsmouth, VA
National Provider Identifier
1134553472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0133000240
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0133000240 | VA | MD | Behavioral 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.