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NPI Code Detail

MEDICARE: MR. STEVEN CARLYLE BLOOM

MEDICARE:  MR. STEVEN CARLYLE BLOOM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorCO

General Provider Information

NPI Number : 1124979174
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN CARLYLE BLOOM
Provider Business Mailing Address
First Line : 6355 W LAKESIDE CT
Second Line :
City : LITTLETON
State : CO
Zip : 80125-9621
Country : US
Telephone Number : 813-766-2124
Fax Number :
Provider Business Practice Location Address
First Line : 6355 W LAKESIDE CT
Second Line :
City : LITTLETON
State : CO
Zip : 80125-9621
Country : US
Telephone Number : 813-766-2124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ MR. STEVEN CARLYLE BLOOM ” Practice Location

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