Rachel Bloom, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

68-021870 Issued in NY

Practice address

79 Walker St FL 2
New York, NY 10013

Phone

(212) 337-3565

NPI assigned

Aug 19, 2016

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Courtney Rennicke, PH.D. PLLC

  dba Rennicke & Associates

  • Clinical Psychologist
  • New York, NY
  • NPI 1558622928
  NPD (past)

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1851846893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133523",
            "telephone_number": "212-337-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10013",
            "telephone_number": "212-337-3565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Broadway",
            "address_2": "Floor 4",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100123920",
            "country_code": "US",
            "telephone_number": "212-337-3565",
            "fax_number": "212-897-3717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "RACHEL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68-021870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Bloom, D.M.D.
• Mollie Bloom
• Naomi Bloom
• Norman David Bloom, M.D.
• Patricia Bloom, MD
• Sharonna Bloom, LMSW
• Stephanie Ada Bloom, CRNP
• Taylor Leigh Bloom, NNP
• Lindsey Anne Bloomenthal
• Adam Charles Bloomfield

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.