Colter Bloxom, LPC
Counselor, Mental Health in Phoenix, AZ. Individual provider (NPI-1).
NPI number1336780329
StatusActive
Last updated in NPPESOct 1, 2019
Details
- NPI
- 1336780329
- Entity type
- Individual (NPI-1)
- Name
- Mr. Colter Bloxom
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 1, 2019
- Last updated
- Oct 1, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 18381 | AZ | Yes |
Practice location
3420 E Shea Blvd Ste 188Phoenix, AZ 85028-3354
Phone 602-529-6557 · Fax 480-485-7938
Mailing address
3420 E Shea Blvd Ste 188Phoenix, AZ 85028-3354
Phone 602-529-6557 · Fax 480-485-7938
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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