Individual provider Active NPI

Karen L Bloomer, LCSW

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1417923384
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30442143A Issued in IN
Practice address
403 E Madison St
South Bend, IN 46617-2322
Phone
(574) 234-0061
Fax
(574) 283-1209
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 30442143A IN Primary

Addresses

Primary practice location

403 E Madison St
South Bend, IN 46617-2322

Mailing address

3714 Franklin St
Michigan City, IN 46360-7311
Phone (219) 861-7243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30442143AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Laporte County Comprehensive Mental Health Council CurrentSince May 20, 2015 Accepting new patients
Madison Center, Inc. Past Accepting new patients

Locations

7224 W 400 N
Michigan City, IN 46360
Phone (219) 879-4621

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417923384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607311",
            "telephone_number": "219-861-7243",
            "fax_number": "219-879-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E MADISON ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172322",
            "telephone_number": "574-234-0061",
            "fax_number": "574-283-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "KAREN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "30442143A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.