Dr Stanley Wayne Blom, PHD in South Bend, IN

Dr Stanley Wayne Blom, PHD is a Psychologist - Clinical based in South Bend, Indiana. Dr Stanley Wayne Blom is licensed to practice in Indiana (license number 20040666A) and his current practice location is 150 W Angela Blvd, South Bend, Indiana. He can be reached at his office (for appointments etc.) via phone at (574) 251-1286.

NPI number for Dr Stanley Wayne Blom is 1538119912 and his current mailing address is 150 W Angela Blvd, South Bend, Indiana. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1538119912.

Contact Information

	Dr Stanley Wayne Blom, PHD
	150 W Angela Blvd, South Bend, IN 46617-1101
	(574) 251-1286
	(574) 232-5386

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Stanley Wayne Blom
Gender	Male
Speciality	Psychologist - Clinical
Location	150 W Angela Blvd, South Bend, Indiana
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1538119912
Provider Enumeration Date: 05/10/2006
Last Update Date: 08/12/2019

Medical Identifiers

Medical identifiers for Dr Stanley Wayne Blom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1538119912	NPI	-	NPPES
200008720	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	20040666A (Indiana)	Primary

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. Dr Stanley Wayne Blom is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Stanley Wayne Blom, PHD 150 W Angela Blvd, South Bend, IN 46617-1101 Ph: (574) 251-1286	Dr Stanley Wayne Blom, PHD 150 W Angela Blvd, South Bend, IN 46617-1101 Ph: (574) 251-1286

Reviews and Comments

Psychologist in South Bend, IN

Rachel Njuguna, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-283-1107 Fax: 574-283-1131
Barbara S Searle, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3603 E Jefferson Blvd, Suiteb, South Bend, IN 46615 Phone: 574-237-1003 Fax: 574-237-1006
Dr. George Gilbert Moss, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 22057 Sandybrook Dr, South Bend, IN 46628 Phone: 574-514-4302
Nicole Gebadlo, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2505 E Jefferson Blvd, South Bend, IN 46615 Phone: 574-289-4831 Fax: 574-234-2075
Vaughn Thomas Mawhinney, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 828 E Colfax Ave, South Bend, IN 46617 Phone: 574-251-1531 Fax: 574-234-5710
Joann Michelle Jackson, PSY.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-533-1234 Fax: 574-537-2652
Jack Garden, HSPP Psychologist Medicare: Medicare Enrolled Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-283-1107 Fax: 574-283-1131

Dr Stanley Wayne Blom, PHD - Psychologist in South Bend, IN