Peter Bloom, PH.D.
Individual provider Active NPI Clinical Psychologist · Alexandria, VA
NPI 1720144306 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720144306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0810000667 (VA)
- Practice address
- 1707 Belle View Blvd
Alexandria, VA 22307-6727 - Phone
- (703) 765-5675
- Fax
- (703) 765-6115
- NPI assigned
- Dec 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810000667 | VA | Yes |
Addresses
Primary practice location
1707 Belle View Blvd
Alexandria, VA 22307-6727
Mailing address
1707 Belle View Blvd
Alexandria, VA 22307-6727
Phone (703) 765-5675
Other providers in Alexandria, VA
- Blessed Smiles
- Blessings of Hope Counseling and Supervision Services, LLC
- Matthew Archer Blomme
- Sharon Elaine Blondeau
- Emily Rachel Parker Blondin
- Sonja Olsen Bloom
- Blossom Center for Integrative Psychiatry LLC
- Blossom Hearing Center LLC
- Belinda Ann Blough
- Miles Blount
All providers in Alexandria, VA · Clinical Psychologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.