Victoria Blom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05683600 Issued in NJ

Practice address

654 E Jersey St
Suite 150C
Elizabeth, NJ 07206-1261

Phone

(413) 885-5763

NPI assigned

May 11, 2017

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

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Victoria Blom LCSW LLC

  • Community/Behavioral Health Agency
  • Millburn, NJ
  • NPI 1861967713
  Medicare reassignment Authorized official
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1609876820
  Medicare reassignment NPD
• Trinitas Regional Medical Center

  dba Trinitas Cranford Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cranford, NJ
  • NPI 1518423698
  NPD

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1396272142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S CLINTON ST",
            "address_2": "APT. 305",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070183051",
            "telephone_number": "413-885-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 E JERSEY ST",
            "address_2": "SUITE 150C",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061261",
            "telephone_number": "413-885-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOM",
        "first_name": "VICTORIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05683600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Stein Blecher, RN, MS, AOCN, APN,C
• Jetta Yael Bleicher, MS, RD
• Michael Bleicher, LCSW
• Blessed Companion Care, Inc
• Heather Wright Bliss
• Bloom Bridge ABA Services Inc
• Cara Bloom
• Bloomberg Counseling Services
• Shari Tellerman Bloomberg, M.S.W., LCSW
• Blue Star Lotus LLC (Blue Star Community Medical Care)

• Clinical Social Worker in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.