Stacy Bloom, R LCSW
NPI #1013120526 in East Norwich, New York
Provider Information
- NPI Number
- 1013120526
- Entity Type
- Individual
- Name
- Stacy Bloom, R LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- R LCSW
- Enumeration Date
- May 8, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 600-11-4B PINE HOLLOW ROAD
- City
- East Norwich
- State
- New York
- ZIP Code
- 11732
- Phone
- (516) 922-6219
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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