JACQUELINE BLOOM (Credential# 1207198) is licensed (Licensed Clinical Social Worker) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2017. The license expiration date date is August 31, 2018. The license status is INACTIVE.
JACQUELINE BLOOM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #58.008717. The credential type is licensed clinical social worker. The effective date is September 1, 2017. The expiration date is August 31, 2018. The business address is 17 Rumpenmile Ave, Westport, CT 06880-5329. The current status is inactive.
| Licensee Name | JACQUELINE BLOOM |
| Credential ID | 1207198 |
| Credential Number | 58.008717 |
| Credential Type | Licensed Clinical Social Worker |
| Business Address |
17 Rumpenmile Ave Westport CT 06880-5329 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2014-08-15 |
| Effective Date | 2017-09-01 |
| Expiration Date | 2018-08-31 |
| Refresh Date | 2018-06-26 |
| Street Address | 17 RUMPENMILE AVE |
| City | WESTPORT |
| State | CT |
| Zip Code | 06880-5329 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Toni L Bucker | 4 Wild Rose Rd, Westport, CT 06880 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jee Hyun Kim | 1 Allen Lane, Westport, CT 06880 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-07-31 |
| Donna Vaccarella | 15 Keyser Rd, Westport, CT 06880 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Sandra Gibson | 12 Bayberry Ln, Westport, CT 06880 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Adil Salam Md | 44 Crawford Rd, Westport, CT 06880 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Joanne C Sosnoski | 24 Hawatha Lane, Westport, CT 06880 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rachel Lynn | 495 Post Rd East, Westport, CT 06880 | Eyelash Technician | ~ |
| Beginnings: An Infant/toddler Program | 71 Hillandale Road, Westport, CT 06880 | Group Child Care Home | 2018-01-01 ~ 2021-12-31 |
| Shelley S Ross | 28 Old Hill Farms Rd, Westport, CT 06880 | Dietitian/nutritionist | 2020-08-01 ~ 2021-07-31 |
| Robert W Van Summern | 279 Wilton Rd, Westport, CT 06880 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06880 | |||
| City | WESTPORT |
| Zip Code | 06880 |
| License Type | Licensed Clinical Social Worker |
| License Type + County | Licensed Clinical Social Worker + WESTPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marjorie E Bloom · Bloom | 132 Beekman Drive, Agawam, MA 01001 | Licensed Clinical Social Worker | 2010-08-01 ~ 2011-07-31 |
| Toni M Bloom | Po Box 336, Brightwood, OR 97011 | Licensed Clinical Social Worker | 1995-06-22 ~ 1996-07-31 |
| Meg Bloom | 167 West Rock Ave., New Haven, CT 06515 | Licensed Clinical Social Worker | 2005-05-20 ~ 2006-06-30 |
| Amy Bloom | 147 Thimble Island Rd, Branford, CT 06405-5722 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Debra K Bloom | 39 Faulkner Drive, Guilford, CT 06437 | Licensed Clinical Social Worker | 2020-04-01 ~ 2021-03-31 |
| Luz Fonseca | 1316 Dew Bloom Road, Valrico, FL 33594 | Licensed Clinical Social Worker | 1998-11-18 ~ 2000-01-31 |
| Edythe Bloom | 51 Old Meadow Rd, West Hartford, CT 06117 | Licensed Clinical Social Worker | ~ 1995-05-31 |
| Bradley W Bloom | 1101 Mill Hill Rd, Southport, CT 06890-3020 | Licensed Clinical Social Worker | 2020-02-01 ~ 2021-01-31 |
| Michelle Jordana Bloom | 84 Brinckerhoff Avenue, Stamford, CT 06905 | Licensed Clinical Social Worker | 2020-02-03 ~ 2021-02-28 |
| Sholom Bloom | 51 Old Meadow Road, West Hartford, CT 06117 | Licensed Clinical Social Worker | ~ 1995-10-31 |
Please comment or provide details below to improve the information on JACQUELINE BLOOM.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).