Provider Demographics
NPI:1336418912
Name:BLUMM, FRANCINE MINDY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:FRANCINE
Middle Name:MINDY
Last Name:BLUMM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:FRANCINE
Other - Middle Name:MINDY
Other - Last Name:BLUMM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 BLUE HILL PLZ
Mailing Address - Street 2:FL 3
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-3104
Mailing Address - Country:US
Mailing Address - Phone:914-366-0887
Mailing Address - Fax:
Practice Address - Street 1:65 PARROTT RD
Practice Address - Street 2:CBI TECH HIGH SCHOOL
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-1025
Practice Address - Country:US
Practice Address - Phone:845-627-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0727151041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool