Provider Demographics
NPI:1699949347
Name:BLUM, NANCY WHITEFIELD (MA, CHT)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:WHITEFIELD
Last Name:BLUM
Suffix:
Gender:F
Credentials:MA, CHT
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:BLOOM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CHT
Mailing Address - Street 1:PO BOX 921
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-0031
Mailing Address - Country:US
Mailing Address - Phone:541-488-5795
Mailing Address - Fax:
Practice Address - Street 1:561 C ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2035
Practice Address - Country:US
Practice Address - Phone:541-621-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist