Individual provider Active NPI

Morgan Blom

  • Clinical Social Worker
  • Newton, IA
National Provider Identifier
1356902787
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096387 Issued in IA
Practice address
1123 1St Ave E Ste 200
Newton, IA 50208-3981
Phone
(641) 792-4012
NPI assigned
Jun 26, 2019
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X 096387 IA Primary

Addresses

Primary practice location

1123 1St Ave E Ste 200
Newton, IA 50208-3981

Mailing address

1123 1St Ave E Ste 200
Newton, IA 50208-3981
Phone (641) 780-3421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005001212 IA Practitioner - Clinical Social Worker 6709284862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 E 17TH St S
Suite 400
Newton, IA 50208-4059
Phone (641) 780-3421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Behavioral Healthcare, Inc CurrentSince Sep 21, 2021 Accepting new patients
Blom Counseling Services Clinical CurrentSince Feb 3, 2023 Accepting new patients
Poweshiek County Mental Health Center Past Accepting new patients

Locations

200 4th Ave W
Grinnell, IA 50112
Phone (641) 236-6137

1123 1st Ave E
Ste 200
Newton, IA 50208
Phone (641) 792-4012

300 E 17th St S
Ste 400
Newton, IA 50208
Phone (641) 780-3421

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1356902787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 1ST AVE E STE 200",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083981",
            "telephone_number": "641-780-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 1ST AVE E STE 200",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083981",
            "telephone_number": "641-792-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOM",
        "first_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "096387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, IA

Sources for this page

Verify at the official NPI Registry.