Carol Blum, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

SIO2684 Issued in NJ

Practice address

20 Nassau St
Suite 315
Princeton, NJ 08542-4509

Phone

(609) 497-4783

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962596403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NASSAU ST",
            "address_2": "SUITE 315",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085424509",
            "telephone_number": "609-497-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NASSAU ST",
            "address_2": "SUITE 315",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085424509",
            "telephone_number": "609-497-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SIO2684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Blake, M.D.
• Kathleen M Bland, LCSW
• Thomas R Blom, M.D.
• Blossom Wellness, LLC
• Amanda Blum, PT
• John Charles Bolen, DMD
• Samantha Bombel, LCSW
• Michael Bonacci, M.S., L.AC.
• Jamie Bonat
• Julie Tolmie Bond, LMFT

• All providers in Princeton, NJ
• Psychologist in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.