McKenzie Lauree Blom, LCSW-ASSOCIATE

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P023063 Issued in NC

Practice address

95 H20 Place Suite 2&3
Surf City, NC 28445

Phone

(910) 375-1565

Fax

(000) 000-0000

NPI assigned

Oct 30, 2025

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1992674881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 H20 PLACE SUITE 2&3",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "28445",
            "telephone_number": "910-375-1565",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 H20 PLACE SUITE 2&3",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "28445",
            "telephone_number": "910-375-1565",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOM",
        "first_name": "MCKENZIE",
        "middle_name": "LAUREE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P023063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beach Care PA
• Benchmark Physical Therapy of NC, LLC
• Chad Douglas Bender, PHARMD
• Big Moves Physical Therapy LLC
• James S Blair III, MD
• Keely Peterson Brown, PT
• Sandra Thompson Brown, M.S.
• Jennifer Nicole Buchanan, PHARMD
• Margaret Lillian Byram, PA-C
• William Jeffrey Callard, MD

• Clinical Social Worker in Surf City, NC
• Providers in Surf City, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.