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CARLYNN CLIFFORD BLOOM LMFT
NPI 1639793359
Counselor - Mental Health in San Anselmo, CA

Active since May 29, 2020Opted out of Medicare · through Jan 5, 2028
PO BOX 2544, SAN ANSELMO, CA 94979(415) 322-0463 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 4, 2025, Dec 4, 2020, May 29, 2020 (3 updates tracked since 2020).

About Carlynn Clifford Bloom Lmft NPPES

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

CARLYNN CLIFFORD BLOOM LMFT (NPI 1639793359) is an individual mental health provider in San Anselmo, California and active in the NPI registry since May 2020. She has opted out of Medicare through January 5, 2028.

NPPES Registry Identity

NPI1639793359
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameCARLYNN CLIFFORD BLOOMCredential: LMFT
Location AddressPO BOX 2544San Anselmo, CA 94979-2544
Mailing AddressPo Box 2544San Anselmo, CA 94979-2544
Phone(415) 322-0463
Sole ProprietorYes
Enumeration DateMay 29, 2020
Last NPPES UpdateFebruary 4, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 4, 2025
✔ NPI 1639793359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
PO BOX 2544, San Anselmo, CA 94979
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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

Carlynn Clifford Bloom Lmft 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 January 5, 2024 through January 5, 2028.

Opt-Out Effective DateJanuary 5, 2024
Opt-Out In Effect ThroughJanuary 5, 2028Opt-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 Carlynn Bloom's NPI number?

The NPI number for Carlynn Bloom is 1639793359. It was assigned to this individual provider in the NPPES registry on May 29, 2020.

Where is Carlynn Bloom located?

Carlynn Bloom practices at PO Box 2544, San Anselmo, CA 94979. The listed phone number is (415) 322-0463.

What is Carlynn Bloom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Carlynn Bloom enrolled in Medicare?

No. Carlynn Bloom has opted out of Medicare through January 5, 2028. 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 Carlynn Bloom was last updated on February 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.