Allan S Bloom, PHD
Individual provider Active NPI Psychologist
NPI 1811974231 · NPPES record last updated Oct 28, 2022
Key facts
- NPI
- 1811974231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PSY1913 (DC)
- Practice address
- 1025 Main Street
West Barnstable, MASSACHUSETTS 02668 - Phone
- (703) 577-3791
- Fax
- (844) 691-1304
- NPI assigned
- Dec 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1913 | DC | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Health Providers PC | Past | Accepting new patients | |
| Cape Cod Psychological Testing, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY1913 | DC | Yes |
Addresses
Primary practice location
1025 Main Street
West Barnstable, MASSACHUSETTS 02668
Mailing address
Landstuhl Regional Medical Center
Attn McEul-DCCS Credentials CMR 402
Apo, AE 09180
Phone 011496371868839
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2022. 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.