Mirelle D. Bloch, Psy.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MIRELLE D. BLOCH, PSY.D., LLC

Practice address

1328 Greenleaf St Unit 4
Evanston, IL 60202-1153

Phone

(872) 226-2313

Fax

(312) 312-9675

NPI assigned

Mar 6, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Mirelle D Bloch, PSYDNPI 1881236917

Title

Clinical Psychologist

Phone

(872) 226-2313

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mirelle Davis Bloch, PSYD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1881236917
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1700644655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 GREENLEAF ST UNIT 4",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021153",
            "telephone_number": "872-226-2313",
            "fax_number": "312-312-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 GREENLEAF ST UNIT 4",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021153",
            "telephone_number": "872-226-2313",
            "fax_number": "312-312-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRELLE D. BLOCH, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "BLOCH",
        "authorized_official_first_name": "MIRELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "872-226-2313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Minkus, LCSW, CADC
• Ruth Ellen Minnick, LPC
• Travis Minniear
• Miora
• Nasima Mir Coria, PHARM. D.
• Donald J Miro, PH.D.
• Roma Mirutenko
• Nabila Mirza
• Ariana Celeste Miserak, LPC
• Shrimant Mishra, MD

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.