Provider Demographics
NPI:1821276569
Name:BLOOM, CATHERINE SUE (LMHP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:SUE
Last Name:BLOOM
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7602 PACIFIC ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-5428
Mailing Address - Country:US
Mailing Address - Phone:402-398-9056
Mailing Address - Fax:402-399-9804
Practice Address - Street 1:7602 PACIFIC ST
Practice Address - Street 2:SUITE 205
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-5428
Practice Address - Country:US
Practice Address - Phone:402-398-9056
Practice Address - Fax:402-399-9804
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8524101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health