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BRADLEY WARREN BLOOM
NPI 1285424804
Social Worker - Clinical in Southport, CT

Active since May 07, 2025Opted out of Medicare · through Apr 16, 2027
1101 MILL HILL RD, SOUTHPORT, CT 06890(203) 451-1599(203) 451-1599 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bradley Warren Bloom NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY WARREN BLOOM (NPI 1285424804) is an individual clinical provider in Southport, Connecticut, licensed in Connecticut (005722) and active in the NPI registry since May 2025. He has opted out of Medicare through April 16, 2027.

NPPES Registry Identity

NPI1285424804
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameBRADLEY WARREN BLOOM
Location Address1101 MILL HILL RDSouthport, CT 06890-3020
Mailing Address1101 Mill Hill RdSouthport, CT 06890-3020 · (203) 451-1599 · Fax (203) 451-1599
Phone(203) 451-1599
Fax(203) 451-1599
Sole ProprietorNo
Enumeration DateMay 7, 2025
NPPES CertifiedMay 7, 2025
✔ NPI 1285424804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CT · 005722
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1101 MILL HILL RD, Southport, CT 06890
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Bradley Warren Bloom has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 16, 2025 through April 16, 2027.

Opt-Out Effective DateApril 16, 2025
Opt-Out In Effect ThroughApril 16, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Bloom's NPI number?

The NPI number for Bradley Bloom is 1285424804. It was assigned to this individual provider in the NPPES registry on May 7, 2025.

Where is Bradley Bloom located?

Bradley Bloom practices at 1101 Mill Hill Rd, Southport, CT 06890. The listed phone number is (203) 451-1599.

What is Bradley Bloom's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Bradley Bloom enrolled in Medicare?

No. Bradley Bloom has opted out of Medicare through April 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Bradley Bloom was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.