Active NPI
Vanessa May Bloom
- Counselor
- Adrian, MI
National Provider Identifier
1679901615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401013911
- Practice address
- 805 W Maumee St
Adrian, MI 49221-1901 - Phone
- (517) 266-8880
- Fax
- (517) 266-8881
- NPI assigned
- Oct 30, 2013
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401013911 | MI | Primary |
Addresses
Primary practice location
805 W Maumee St
Adrian, MI 49221-1901
Mailing address
805 W Maumee St
Adrian, MI 49221-1901
Phone (517) 266-8880
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 |
|---|---|---|---|
| 6401013911 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkside Family Counseling, LLC | Counselor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Counselor
- Adrian, MI
- NPI 1710164652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383091200000",
"number": "1679901615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 W MAUMEE ST",
"city": "ADRIAN",
"state": "MI",
"postal_code": "492211901",
"telephone_number": "517-266-8880",
"fax_number": "517-266-8881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 W MAUMEE ST",
"city": "ADRIAN",
"state": "MI",
"postal_code": "492211901",
"telephone_number": "517-266-8880",
"fax_number": "517-266-8881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "VANESSA",
"middle_name": "MAY",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-30",
"last_updated": "2013-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401013911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Adrian, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.