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NPI Code Detail

MEDICARE: MS. SHERRI R BLOOM LCSW-C

MEDICARE:  MS. SHERRI R BLOOM  LCSW-C
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
1104100000XSocial Worker11537MD

General Provider Information

NPI Number : 1689670317
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHERRI R BLOOM LCSW-C
Provider Business Mailing Address
First Line : 3501 SINCLAIR LN
Second Line :
City : BALTIMORE
State : MD
Zip : 21213-2029
Country : US
Telephone Number : 410-558-4888
Fax Number : 410-327-1694
Provider Business Practice Location Address
First Line : 1245 EASTERN BLVD
Second Line :
City : BALTIMORE
State : MD
Zip : 21221-3422
Country : US
Telephone Number : 410-558-4700
Fax Number : 410-780-0364
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/08/2007

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Directions to “ MS. SHERRI R BLOOM LCSW-C” Practice Location

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