DR. ELISABETH BLOOM (NPI# 1902246010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902246010 |
| Entity Type | Individual |
| Full Name | DR. ELISABETH BLOOM |
| Credential | PSY.D. |
| Practice Address |
510 Sw 3rd Ave Ste 200 Portland OR 97204-2507 |
| Mailing Address |
Po Box 82372 Portland OR 97282-0372 |
| Practice Telephone | 9177270825 |
| Mailing Telephone | 9177270825 |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2020-07-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3072 | OR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
021321 | NY | Behavioral Health & Social Service Providers |
| Street Address |
510 SW 3RD AVE STE 200 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97204-2507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003000944 | Alana J Duschane | Psychologist | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2007-09-04 |
| 1457952277 | Gifted Behavioral Health | Nurse Practitioner | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2020-11-06 |
| 1891304986 | Bloom Psychotherapy LLC | Community/Behavioral Health | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2020-07-24 |
| 1467011577 | Shearwater Counseling Services | Social Worker | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2019-06-12 |
| 1497220206 | Joie De Vivre Counseling LLC | Case Management | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2018-10-08 |
| 1134601727 | Jared Israel Best | Counselor | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2018-08-30 |
| 1831688563 | Katon Marie Abnar Behbahani | Counselor | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2018-05-08 |
| 1780074807 | Michael Crockett | Psychologist | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2015-01-27 |
| 1477941110 | Joan Laguzza | Social Worker | 510 Sw 3rd Ave Ste 200, Portland, OR 97204-2507 | 2015-01-05 |
| 1679768188 | Erin Leigh Spencer | Marriage & Family Therapist | 510 Sw 3rd Ave Ste 200, Portland, OR 97204 | 2007-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922662352 | Sleep Management, L.L.C. | Respiratory Therapist, Registered | 1050 Sw 6th Avenue, Suite 1100 Office # 52, Portland, OR 97204 | 2019-05-01 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1790133031 | Modupe Desiree Bansile | Counselor | 209 Sw Fourth Ave, Suite 520, Portland, OR 97204 | 2016-05-26 |
| 1841655834 | Isabella Zaragoza | Counselor | 421 Sw Oak St Suite 520, Portland, OR 97204 | 2015-12-18 |
| 1952737736 | Hessler-cohen Enterprises LLC | Acupuncturist | 310 Sw 4rth Avenue, Suite 725, Portland, OR 97204 | 2013-09-24 |
| 1144583378 | Angela Nicole Johnson | Physical Therapist | 555 Sw Oak Street, Portland, OR 97204 | 2012-06-22 |
| 1255614624 | Jaclyn Rene Jones | Nurse Practitioner | 601 Sw 4th Ave, Portland, OR 97204 | 2011-09-22 |
| 1407148398 | Cristianne Paulsen | Dental Hygienist | 426 Sw Stark, 9th Floor, Portland, OR 97204 | 2011-05-10 |
| 1396928255 | Jessica L Hall | Counselor | 421 Sw Oak Street, Suite 520, Portland, OR 97204 | 2007-12-13 |
| 1699896274 | Julie Anne Oyemaja | Counselor | 421 Sw Oak St., Ste. 210, Portland, OR 97204 | 2007-04-02 |
| Find all providers in zip 97204 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1093373631 | Emily Catherine Stasko | Psychologist | 1950 Nw Raleigh St Apt 201, Portland, OR 97209-1775 | 2019-05-29 |
| 1174094544 | Juniper Psychological Services | Psychologist | 2827 Ne Alberta St, Portland, OR 97211-6350 | 2018-12-11 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1467941831 | Shannon Madore | Psychologist | 3710 Sw Us Veterans Hospital Rd # R&d66, Portland, OR 97239-2964 | 2018-05-01 |
| 1033637202 | Kaylin Jones | Psychologist | 1235 Se Division Street, Suite 115, Portland, OR 97202-9720 | 2017-09-07 |
| Find all providers in PORTLAND | ||||
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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.