Tracy Bloom, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0015771 Issued in CO

Practice address

155 Inverness Dr W
Englewood, CO 80112-5000

Phone

(303) 730-8858

NPI assigned

Aug 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tracy Esquibel Former name

Electronic endpoints 1

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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1386257939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2183 S ELDRIDGE ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802285935",
            "telephone_number": "303-653-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 INVERNESS DR W",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125000",
            "telephone_number": "303-730-8858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2183 S Eldridge St",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802285935",
            "country_code": "US",
            "telephone_number": "720-663-1148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17301 W Colfax Ave Ste 275",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804014886",
            "country_code": "US",
            "telephone_number": "720-456-5420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "TRACY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0015771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Golden",
            "affiliation": "Y",
            "affiliationName": "Behavioral Treatment Services",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1333 W 120th Ave",
            "address_2": "#109",
            "city": "Westminster",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802342708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "ESQUIBEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Englewood, CO
• Providers in Englewood, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.