Active NPI
Peter Bloom, PH.D.
- Clinical Psychologist
- Alexandria, VA
National Provider Identifier
1720144306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810000667
- Practice address
- 1707 Belle View Blvd
Alexandria, VA 22307-6727 - Phone
- (703) 765-5675
- Fax
- (703) 765-6115
- NPI assigned
- Dec 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 0810000667 | VA | Primary |
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
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720144306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1707 BELLE VIEW BLVD",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223076727",
"telephone_number": "703-765-5675",
"fax_number": "703-765-6115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1707 BELLE VIEW BLVD",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223076727",
"telephone_number": "703-765-5675",
"fax_number": "703-765-6115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "PETER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810000667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
- Blessed Smiles
- Blessings of Hope Counseling and Supervision Services, LLC
- Matthew Archer Blomme, MA
- Sharon Elaine Blondeau, RN
- Emily Rachel Parker Blondin, PT, DPT, MSPT
- Sonja Olsen Bloom, M.A.
- Blossom Center for Integrative Psychiatry LLC (Blossom Center for Integrative Psychiatry)
- Blossom Hearing Center LLC
- Belinda Ann Blough, PTA
- Miles Blount
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.