Active NPI
Julie G Bloom, LCSW
- Clinical Social Worker
- Bloomington, IN
National Provider Identifier
1770617284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34003031A
- Practice address
- 101 W Kirkwood Ave
Ste 213
Bloomington, IN 47404-6129 - Phone
- (812) 332-9200
- Fax
- (812) 334-2522
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- 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 Social Worker | 1041C0700X | 34003031A | IN | Primary |
Addresses
Primary practice location
101 W Kirkwood Ave
Ste 213
Bloomington, IN 47404-6129
Mailing address
101 W Kirkwood Ave
Ste 213
Bloomington, IN 47404-6129
Phone (812) 332-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000309908 | Other | IN | ANTHEM |
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 |
|---|---|---|---|
| 34003031A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770617284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W KIRKWOOD AVE",
"address_2": "STE 213",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474046129",
"telephone_number": "812-332-9200",
"fax_number": "812-334-2522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W KIRKWOOD AVE",
"address_2": "STE 213",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474046129",
"telephone_number": "812-332-9200",
"fax_number": "812-334-2522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "JULIE",
"middle_name": "G",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34003031A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000309908",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
- Michael James Paul Block, LCSW
- Brianna Blohm
- Lugenia D Blondell, NP
- Bloom in Nutrition Services
- Bloom Pediatric Therapy
- Bloomington Advanced Surgery Center, LLC (Bloomington Advanced Surgery Center)
- Bloomington Al, LLC
- Bloomington Anesthesiologists PC
- Bloomington Area Birth Services
- Bloomington ASC, LLC (Indiana Specialty Surgery Center)
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.