Lynette Careen Bloom, CADC I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15-06-02 Issued in OR

Practice address

1011 Commercial St NE Ste 110
Salem, OR 97301-1036

Phone

(503) 983-9900

Fax

(503) 983-9899

NPI assigned

Jul 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1215249081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 HAWK DR",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975023567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 COMMERCIAL ST NE STE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011036",
            "telephone_number": "503-983-9900",
            "fax_number": "503-983-9899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "837 E Main St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975047151",
            "country_code": "US",
            "telephone_number": "541-772-2763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "LYNETTE",
        "middle_name": "CAREEN",
        "credential": "CADC I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "15-06-02",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadie Blommendahl
• Tori Ann Blomquist, M.S, CCC-A
• Debra Ida Blondo, RN
• Andrew Lytle Blood
• Bloom Physical Therapy
• Bloomer Counseling and Consulting, Inc.
• Tanya Ann Bloomfield
• Blossom Psychiatric Care LLC
• Blue Iris River Counseling LLC
• Kaylyn Marie Blum, ATC

• Addiction (Substance Use Disorder) Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.