Victoria Blom LCSW LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

VICTORIA BLOM LCSW LLC

Practice address

318 Main St Ste 205
Millburn, NJ 07041-1181

Phone

(413) 885-5763

NPI assigned

Oct 8, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Victoria V Blom, LCSWNPI 1396272142

Title

Sole Member

Phone

(413) 885-5763

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victoria Blom, LCSW

  • Clinical Social Worker
  • Elizabeth, NJ
  • NPI 1396272142
  Medicare reassignment Authorized official
• Maria A Santiago, LCSW

  • Clinical Social Worker
  • Elizabeth, NJ
  • NPI 1447731005
  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1861967713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 MAIN ST STE 205",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411181",
            "telephone_number": "413-885-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MAIN ST STE 205",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411181",
            "telephone_number": "413-885-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA BLOM LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "BLOM",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "413-885-5763",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Traci M Vogler

• Community/Behavioral Health Agency in Millburn, NJ
• Providers in Millburn, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.