Michelle Jordana Bloom, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73081585 Issued in NY

Practice address

1651 3Rd Ave
Suite 201
New York, NY 10128-3679

Phone

(516) 526-7120

NPI assigned

Dec 14, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1316240385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EAST 83RD STREET",
            "address_2": "APT 4L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10028",
            "telephone_number": "516-526-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 3RD AVE",
            "address_2": "SUITE 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283679",
            "telephone_number": "516-526-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "MICHELLE",
        "middle_name": "JORDANA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-14",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "72 082712",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73081585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Bloom
• Katherine Bloom
• Lawrence Michael Bloom, M.D.
• Matthew Ira Bloom, D.D.S.
• Michael Lloyd Bloom, D.D.S.
• Mitchell Bloom, D.M.D.
• Mollie Bloom
• Naomi Bloom
• Norman David Bloom, M.D.
• Patricia Bloom, MD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.