Haley Elizabeth Bloom

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P019236 Issued in NC

Practice address

312 W Millbrook Rd Ste 129
Raleigh, NC 27609-4398

Phone

(919) 877-6101

Fax

(919) 876-4953

NPI assigned

Dec 4, 2023

Last updated

Dec 4, 2023By the provider in NPPES

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A New Life Services Inc

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1679882393
  NPD

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1235906942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 PALMER DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275277540",
            "telephone_number": "919-879-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W MILLBROOK RD STE 129",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094398",
            "telephone_number": "919-877-6101",
            "fax_number": "919-876-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "HALEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danica Bloodgood, COTA
• Bloodline Mobile Phlebotomy Service
• Bloom Holistic Bodywork
• Bloom Joy LLC
• Allan Albert Bloom, PH.D
• Tina Marie Bloomer, MS, RD/LDN
• Blooming Minds, PLLC
• Bloomsbury Therapy
• Bloomwell Behavioral Health Inc.
• Blossom & Bloom Wellness Services, PLLC

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.