Provider Demographics
NPI:1336035898
Name:BLISS BEHAVIORALL HEALTH
Entity type:Organization
Organization Name:BLISS BEHAVIORALL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, NPPMH
Authorized Official - Phone:606-273-6241
Mailing Address - Street 1:68 FALLS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-7039
Mailing Address - Country:US
Mailing Address - Phone:606-273-6241
Mailing Address - Fax:
Practice Address - Street 1:68 FALLS CREEK DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-7039
Practice Address - Country:US
Practice Address - Phone:606-273-6241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty