Provider Demographics
NPI:1386025161
Name:SIMPLY LIVING BLESSED, LLC
Entity Type:Organization
Organization Name:SIMPLY LIVING BLESSED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-255-5408
Mailing Address - Street 1:604 SHIRLEY MANOR RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-2319
Mailing Address - Country:US
Mailing Address - Phone:443-255-5408
Mailing Address - Fax:410-581-5058
Practice Address - Street 1:9921 REISTERSTOWN RD
Practice Address - Street 2:STE 1D
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3900
Practice Address - Country:US
Practice Address - Phone:410-581-5057
Practice Address - Fax:410-581-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15546101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty