Bloom, Caitlin

Bloom, Caitlin is an individual health care provider with primary practice located at 3401 45Th St S Ste A , Fargo ND 58104. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Bloom, Caitlin can be contacted via phone (701) 356-4384.

Contact Information

Primary practice address
3401 45Th St S Ste A Fargo ND 58104
Phone: (701) 356-4384
Fax: (701) 356-4383
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1255791620
LBN Legal business name Bloom, Caitlin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 29th, 2016
Last updated Jul 26th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255791620 NPPES
North Dakota MEDICAID 1462276

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