Carlynn Clifford Bloom, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

PO Box 2544
San Anselmo, CA 94979-2544

Phone

(415) 322-0463

NPI assigned

May 29, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 5, 2024 through Jan 5, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• North Marin Community Services

  • Community/Behavioral Health Agency
  • Novato, CA
  • NPI 1861556573

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1639793359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2544",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949792544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 2544",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949792544",
            "telephone_number": "415-322-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "CARLYNN",
        "middle_name": "CLIFFORD",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taryn Bernstein, LMFT
• Diane Bielefeld, LMFT
• Julie Birnbaum, MA, CD
• Jessica Michelle Blake, M.F.T.
• Martin G Blinder, MD
• Lester Marc Bornheim, B.S,, PHD
• Boyer B. Cole, N.D., Naturopathic Medical Doctor
• Kate E Brennan, MFT
• David Brody, MD
• Michael Broffman, LAC

• Mental Health Counselor in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.