Active NPI
Audrey Bloom, LCSW
- Clinical Social Worker
- Miami, FL
National Provider Identifier
1487948972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10388
- Practice address
- 2000 S Dixie Hwy
Suite 104, Coconut Grove Center
Miami, FL 33133-2456 - Phone
- (305) 301-8251
- NPI assigned
- Jun 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10388 | FL | Primary |
Addresses
Primary practice location
2000 S Dixie Hwy
Suite 104, Coconut Grove Center
Miami, FL 33133-2456
Mailing address
17142 SW 112TH CT
Miami, FL 33157-3907
Phone (305) 301-8251
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10388 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306972800000",
"number": "1487948972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17142 SW 112TH CT",
"city": "MIAMI",
"state": "FL",
"postal_code": "331573907",
"telephone_number": "305-301-8251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 S DIXIE HWY",
"address_2": "SUITE 104, COCONUT GROVE CENTER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331332456",
"telephone_number": "305-301-8251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "AUDREY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-02",
"last_updated": "2011-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "10388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.