NPIMap

Organization Active NPI

Bradley W Bloom LCSW LLC

  • Social Worker
  • Fairfield, CT
National Provider Identifier
1992983027
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
005722 Issued in CT
Legal business name
BRADLEY W BLOOM LCSW LLC
Practice address
110 Oldfield Dr
Fairfield, CT 06824-6414
Phone
(203) 451-1599
NPI assigned
Jan 31, 2008
Last updated
Sep 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Authorized official

Name
Mr. Bradley Warren Bloom, LCSWNPI 1285424804
Title
Licensed Clinical Social Worker
Phone
(203) 451-1599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 034343 NY
Social Worker 104100000X 005722 CT Primary

Addresses

Primary practice location

110 Oldfield Dr
Fairfield, CT 06824-6414

Mailing address

110 Oldfield Dr
Fairfield, CT 06824-6414
Phone (203) 451-1599

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1992983027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OLDFIELD DR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246414",
            "telephone_number": "203-451-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OLDFIELD DR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246414",
            "telephone_number": "203-451-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY W BLOOM LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "203-451-1599",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "034343",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "005722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.