Active NPIIndividual provider

Charles M Bloom, Jr., QMHP

Counselor, Mental Health in Springfield, Oregon

NPI Number1699320325
Practice location
1651 Centennial Blvd, Springfield, OR 97477-3363
Fax
541-684-4156
Last updated
January 6, 2020

Charles M Bloom, Jr., QMHP is a Counselor, Mental Health based in Springfield, OR. Charles M Bloom, Jr., QMHP holds the professional credentials of QMHP. The NPI number for Charles M Bloom, Jr., QMHP is 1699320325. The current practice location address is 1651 Centennial Blvd, Springfield, OR 97477-3363 and the office can be reached by phone at 541-726-2467 and by fax at 541-684-4156. The NPI was assigned on August 8, 2019 and the record was last updated in NPPES on January 6, 2020.

●Provider Profile Details

NPI Number
1699320325
Provider Name
Charles Michael Bloom, Jr.
Credential
QMHP
Entity Type
Individual (Type 1 NPI)
Gender
Male
Primary Taxonomy
Counselor, Mental Health · 101YM0800X
Sole Proprietor
No
Enumeration Date
August 8, 2019
Last Update Date
January 6, 2020
Certification Date
January 6, 2020
NPI Status
Active

◉Business Practice Location Address

Address
1651 Centennial Blvd
Springfield, OR 97477-3363
State
Oregon
ZIP
97477-3363
Country
US
Phone Number
541-726-2467
Fax Number
541-684-4156

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✉Business Mailing Address

Address
687 Cheshire Ave
Eugene, OR 97402-5060
City
Eugene
State
OR
ZIP
97402-5060
Phone Number
541-684-4100
Fax Number
541-684-4156

✎Taxonomy & License Information

TaxonomyCodePrimaryLicenseState
Counselor, Mental Health101YM0800XYes——

#Other Provider Identifiers

No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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?Frequently Asked Questions

What is the NPI number of Charles M Bloom, Jr., QMHP?

The NPI number of Charles M Bloom, Jr., QMHP is 1699320325. It was assigned on August 8, 2019 and is currently active in the NPPES registry.

What is the specialty of Charles M Bloom, Jr., QMHP?

Charles M Bloom, Jr., QMHP is registered under the primary taxonomy Counselor, Mental Health (code 101YM0800X).

Where does Charles M Bloom, Jr., QMHP practice?

The practice location is 1651 Centennial Blvd, Springfield, OR 97477-3363. The office can be reached at 541-726-2467 (phone) or 541-684-4156 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1699320325 directly on the NPPES registry website at npiregistry.cms.hhs.gov.

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