CHARLES MICHAEL BLOOM, JR. (NPI# 1699320325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699320325 |
Entity Type | Individual |
Full Name | CHARLES MICHAEL BLOOM, JR. |
Credential | QMHP |
Practice Address |
1651 Centennial Blvd Springfield OR 97477-3363 |
Mailing Address |
687 Cheshire Ave Eugene OR 97402-5060 |
Practice Telephone | 5417262467 |
Practice Fax Number | 5416844156 |
Mailing Telephone | 5416844100 |
Mailing Fax Number | 5416844156 |
Enumeration Date | 2019-08-08 |
Last Update Date | 2020-01-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
Street Address |
1651 CENTENNIAL BLVD |
City | SPRINGFIELD |
State | OR |
Zip Code | 97477-3363 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477666253 | Sharon Eileen Watters | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2006-08-16 |
1790337541 | Christopher Doremus | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2019-07-11 |
1346806213 | Heather Thorn | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2019-05-15 |
1467926634 | Naomi Suzanne Decelles | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2019-01-21 |
1407328198 | Eva Julia Williams | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2018-12-19 |
1003383407 | Sara Jane Renee Salcido | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2018-10-24 |
1376056333 | Tessa Diane Brahm | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2017-11-13 |
1972016228 | Cheyenne Lee Depew | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2017-11-08 |
1396256277 | Kyle Robert Dickey | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2017-10-18 |
1568985398 | William Wilson | Counselor | 1651 Centennial Blvd, Springfield, OR 97477-3363 | 2017-07-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
Find all providers in zip 97477 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619576022 | Christine Cremonni | Counselor | 451 Wayne Ave, Springfield, PA 19064-2618 | 2020-10-19 |
1710585252 | Andrada Mihaila | Counselor | 120 Maple St Ste 301, Springfield, MA 01103-2216 | 2020-10-16 |
1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
1205443462 | India Iasia Kyles | Counselor | 82 Tilton St, Springfield, MA 01109-2332 | 2020-09-30 |
1437765161 | Sarissa Joy Adams | Counselor | 1915 E Nottingham St, Springfield, MO 65804-7733 | 2020-09-18 |
1568098952 | Jennifer Corsi | Counselor | 130 Maple St Ste 201, Springfield, MA 01103-2214 | 2020-03-17 |
1245865500 | Annette Lynn Brandenburg | Counselor | 1736 E Sunshine St Ste 811, Springfield, MO 65804-1334 | 2020-03-06 |
1962045443 | Emilie Noel Phillips | Counselor | 3826 E Lomita St, Springfield, MO 65809-3710 | 2019-10-28 |
1265082234 | Sierra Jane Forney | Counselor | 98 Garnet St, Springfield, MA 01129-1908 | 2019-09-12 |
1700438678 | Julie Ann Blythe | Counselor | 620 N Walnut St, Springfield, IL 62702-4930 | 2019-07-11 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 97477 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.