MR. DAVID JONATHAN BLEECKER


Address: 627 North Morton St, Ste 202, Bloomington, IN 47404-3750
Phone: 8123232061

MR. DAVID JONATHAN BLEECKER (NPI# 1376551242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376551242
Entity Type Individual
Full Name MR. DAVID JONATHAN BLEECKER
Credential PHD
Practice Address 627 North Morton St
Ste 202
Bloomington
IN 47404-3750
Mailing Address 4217 East Penn Court
Bloomington
IN 47408-3124
Practice Telephone 8123232061
Mailing Telephone 8123328975
Enumeration Date 2006-08-04
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
20040212 IN Behavioral Health & Social Service Providers

Office Location

Street Address 627 NORTH MORTON ST
STE 202
City BLOOMINGTON
State IN
Zip Code 47404-3750

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1194184465 Chjl LLC Psychologist 8120 Penn Ave S Ste 252, Bloomington, MN 55431-1358 2016-02-16
1992100077 Lindeman and Associates, LLC Psychologist 3802 E 3rd St, Suite 220, Bloomington, IN 47401-5504 2014-10-30
1255772174 Amanda Quinby Psychologist 205 N College Ave Ste 512, Bloomington, IN 47404-3952 2013-07-08
1457609802 Jason Vasquez Psychologist 2416 Washington, A-3, Bloomington, IL 61704 2012-08-16
1710282058 Annorah Sheeran Moorman Psychologist 1319 Fell Ave, Bloomington, IL 61701-1828 2011-01-18
1477860609 Hoffmann Burchett Psychological Services, LLC Psychologist 205 N Williamsburg Dr, Suite F, Bloomington, IL 61704-7706 2010-09-09
1356654693 James Wiltz Psychologist 2745 E Elderberry Ct, Bloomington, IN 47401-4307 2010-07-15
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City BLOOMINGTON
Zip Code 47404

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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