Provider Demographics
NPI:1598134868
Name:BLOOM ASSOCIATES, LLC
Entity Type:Organization
Organization Name:BLOOM ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLOOM-RAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-239-8076
Mailing Address - Street 1:14 CLAVENDON COURT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748
Mailing Address - Country:US
Mailing Address - Phone:908-239-8076
Mailing Address - Fax:
Practice Address - Street 1:210 WEST FRONT STREET
Practice Address - Street 2:SUITE 206A
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:908-239-8076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056470001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty