Provider Demographics
NPI:1033468707
Name:BLOOM-CARLIN, EMILY
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:BLOOM-CARLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3355
Mailing Address - Country:US
Mailing Address - Phone:617-234-5340
Mailing Address - Fax:617-234-5344
Practice Address - Street 1:678 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3355
Practice Address - Country:US
Practice Address - Phone:617-234-5340
Practice Address - Fax:617-234-5344
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker