Individual provider · Type 1 NPI

Larry Jay Bloom, PhD

Health Service Psychologist · Fort Collins, CO

NPI number 1407878051 Active

Practice location

Of Psychology Colorado State University
Fort Collins, CO 80523-0001

Mailing address

1000 Southpark Drive
Littleton, CO 80120-5654

Specialties and licenses

TaxonomyCodeLicense
Health Service Psychologist Primary 103TH0100X500 (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.