Michelle Bloom, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1901607 Issued in OH

Practice address

905 Nebraska Ave
Toledo, OH 43607-4222

Phone

(419) 255-4050

NPI assigned

Nov 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1841703444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ASHLAND AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 NEBRASKA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436074222",
            "telephone_number": "419-255-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "MICHELLE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey P Blood, D.O.
• Jordyn M Blood, ATC
• Paula Michelle Blood, RN
• Chelsey Lynn Bloom
• Lee James Bloom, LPCC
• Blossom Home Care
• Amanda Blossom, QMHS, LSW
• George B Blossom, D.O.
• Jamie Blossom, MSW, LISW
• Blue Cross Home Care LLC

• Clinical Social Worker in Toledo, OH
• Providers in Toledo, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.