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General NPI Number Information
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NPI Number | 1932215381
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Entity Type | Individual
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Provider Name | MAGGIE J. BLOOMFIELD LCSWR, CASAC, SAP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 09/21/2024
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Provider Practice Location Address
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Address Line | C/O INTEGRATIVE COUNSELING SERVICES 10 OAK #3
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City | WESTHAMPTON BEACH
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State | NY
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Zip | 11978
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Country | US
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Telephone | 631-922-2312
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Fax | 631-288-8576
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Provider Business Mailing Address
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Address Line | C/O INTEGRATIVE COUNSELING SERVICES 10 OAK #3
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City | WESTHAMPTON BEACH
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State | NY
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Zip | 11978
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Country | US
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Telephone | 631-922-2312
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Fax | 631-288-8576
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5915
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12685
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PR057530
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License Number State | NY
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