Individual provider · Type 1 NPI

Jared Dicicco-Bloom

Mental Health Counselor · New York, NY

NPI number 1508488172 Active

Practice location

303 5th Ave Rm 1003
New York, NY 10016-6639

Call (212) 686-3535 Map

Mailing address

1660 Madison Ave Apt 10A
New York, NY 10029-3117

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1508488172

Jared Dicicco-Bloom's National Provider Identifier is 1508488172, issued on May 17, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in New York, NY. The record was last updated on May 17, 2020.