Provider Demographics
NPI:1740523240
Name:HILDA HANNAH BLOOMBERG,LICSW,INC.
Entity type:Organization
Organization Name:HILDA HANNAH BLOOMBERG,LICSW,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:HANNAH
Authorized Official - Last Name:BLOOMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:401-369-1916
Mailing Address - Street 1:117 GLEANER CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:N SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1204
Mailing Address - Country:US
Mailing Address - Phone:401-369-1916
Mailing Address - Fax:401-647-7719
Practice Address - Street 1:117 GLEANER CHAPEL RD
Practice Address - Street 2:
Practice Address - City:N SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1204
Practice Address - Country:US
Practice Address - Phone:401-369-1916
Practice Address - Fax:401-647-7719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW01403101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty