Active NPI
Sandra Bloom
- Clinical Social Worker
- Silver Spring, MD
National Provider Identifier
1548630965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12172
- Practice address
- 12073 Tech Rd Ste B
Silver Spring, MD 20904-7874 - Phone
- (301) 593-1315
- Fax
- (301) 681-4699
- NPI assigned
- Sep 28, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 12172 | MD | Primary |
Addresses
Primary practice location
12073 Tech Rd Ste B
Silver Spring, MD 20904-7874
Mailing address
12073 Tech Rd Ste B
Silver Spring, MD 20904-7874
Phone (301) 593-1315
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12172 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443398400000",
"number": "1548630965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12073 TECH RD STE B",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209047874",
"telephone_number": "301-593-1315",
"fax_number": "301-681-4699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12073 TECH RD STE B",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209047874",
"telephone_number": "301-593-1315",
"fax_number": "301-681-4699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-28",
"last_updated": "2015-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "12172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.