Nicola S Bloom

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW24239 Issued in FL

Practice address

1317 Edgewater Drive
Suite 2019
Orlando, FL 32804

Phone

(954) 613-9591

NPI assigned

May 8, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Lib Experience LLC

  • Clinical Social Worker
  • Hollywood, FL
  • NPI 1316830656
  NPD Authorized official

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1174212872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4429 HOLLYWOOD BLVD # 4562",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330816001",
            "telephone_number": "954-613-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 EDGEWATER DRIVE",
            "address_2": "SUITE 2019",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "954-613-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "NICOLA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "AZ",
            "license": "ALPP-315438",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "FL",
            "license": "202303071",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carina Blondet
• Bloom Behavior Services LLC
• Bloom Counseling & Co, LLC (Bloom Counseling & Co)
• Bloom Medical Clinic LLC
• Bloom True Therapy LLC
• Scott William Bloom, M.D.
• Alyssa Bloomer, BCBA
• Blooming Health Center LLC
• Blooming Keiki Behavioral Services LLC
• Blooming Roses LLC

• Clinical Social Worker in Orlando, FL
• Providers in Orlando, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.