Philip Bloomer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00945355 Issued in WV

Practice address

800 20TH St
Huntington, WV 25703-1850

Phone

(304) 696-8700

Fax

(304) 636-8701

NPI assigned

Jul 30, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A Center 4 Change

  • Mental Health Counselor
  • Ashland, KY
  • NPI 1013450212
  NPD (past)

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1265864425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 20TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031850",
            "telephone_number": "304-696-8700",
            "fax_number": "304-636-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 20TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031850",
            "telephone_number": "304-696-8700",
            "fax_number": "304-636-8701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 S Front Ave",
            "address_purpose": "LOCATION",
            "city": "Prestonsburg",
            "state": "KY",
            "postal_code": "41653",
            "country_code": "US",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "PHILIP",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "5152",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00945355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30610026",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Blizzard, COTA/L
• Dina Christina Blom, M.D.
• Paul Henry Blom, MD
• Gustav A Blomquist, MD
• Aiden L Blond
• Allie N Blosser
• Katea Blue
• Elutea Blum, R.PH.
• Ciera Cheyenne Board
• Nancy Bockway, M.A.

• Clinical Social Worker in Huntington, WV
• Providers in Huntington, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.