Lynn Marie Bloom, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Golden Valley, Minnesota. Her current practice location is
5905 Golden Valley Rd, Suite 100, Golden Valley, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(763) 225-4052.
Lynn Marie Bloom is licensed to practice in Minnesota (license number 14996) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1255734240.
Healthcare Provider's Profile
| Full Name | Lynn Marie Bloom |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 5905 Golden Valley Rd, Golden Valley, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1255734240
- Provider Enumeration Date: 10/03/2014
- Last Update Date: 10/03/2014
Medicare PECOS Information:
- PECOS PAC ID: 6608194154
- Enrollment ID: I20150413000862
Medical Identifiers
Medical identifiers for Lynn Marie Bloom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1255734240 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 302028 (Minnesota) | Secondary |
| 1041C0700X | Social Worker - Clinical | 14996 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lynn Marie Bloom allows following entities to bill medicare on her behalf.
| Entity Name | Volunteers Of America Mn/wi |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093769572
PECOS PAC ID: 8123050259
Enrollment ID: O20050915000161 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lynn Marie Bloom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Lynn Marie Bloom, LICSW
5905 Golden Valley Rd, Suite 100,
Golden Valley, MN 55422-4463
Ph: (763) 225-4052 | Lynn Marie Bloom, LICSW
5905 Golden Valley Rd, Suite 100,
Golden Valley, MN 55422-4463
Ph: (763) 225-4052 |
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