Individual provider · Type 1 NPI
Larry Jay Bloom, PhD
Health Service Psychologist · Fort Collins, CO
Practice location
Of Psychology Colorado State University
Fort Collins, CO 80523-0001
Mailing address
1000 Southpark Drive
Littleton, CO 80120-5654
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Psychologist Primary | 103TH0100X | 500 (CO) |
Health Service Psychologist: A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
About NPI 1407878051
Larry Jay Bloom, PhD's National Provider Identifier is 1407878051, issued on Jul 24, 2006. The primary taxonomy on file is Health Service Psychologist (103TH0100X), and the practice location is in Fort Collins, CO. The record was last updated on Jul 28, 2010.