Individual
MS. CLAIRE T RUSSELL-BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LICSW
Contact information
Practice address
20 FAIR ST, NEWBURYPORT, MA 01950-2847
(978) 270-1183
Mailing address
20 FAIR ST, NEWBURYPORT, MA 01950-2847
(978) 270-1183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
122527
MA
Other
Enumeration date
10/20/2019
Last updated
03/27/2020
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