Organization
BRADLEY W BLOOM LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY WARREN BLOOM LCSW (LICENSED CLINICAL SOCIAL WORKER)
(203) 451-1599
Entity
Organization
Contact information
Practice address
110 OLDFIELD DR, FAIRFIELD, CT 06824-6414
(203) 451-1599
Mailing address
110 OLDFIELD DR, FAIRFIELD, CT 06824-6414
(203) 451-1599
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
005722
CT
104100000X
Social Worker
034343
NY
Other
Enumeration date
01/31/2008
Last updated
09/08/2009
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