Provider Demographics
NPI:1295383982
Name:HOLLAND, BLISS (LCSW)
Entity Type:Individual
Prefix:
First Name:BLISS
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 S VALENTIA ST UNIT 134
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-6817
Mailing Address - Country:US
Mailing Address - Phone:303-671-9201
Mailing Address - Fax:
Practice Address - Street 1:1011 S VALENTIA ST UNIT 134
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-6817
Practice Address - Country:US
Practice Address - Phone:303-671-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9918191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical