Provider Demographics
NPI:1639714793
Name:BLISS THERAPY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:BLISS THERAPY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEVEILLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-922-3436
Mailing Address - Street 1:15715 S DIXIE HWY STE 325
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1883
Mailing Address - Country:US
Mailing Address - Phone:305-922-3426
Mailing Address - Fax:
Practice Address - Street 1:15715 S DIXIE HWY STE 325
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1883
Practice Address - Country:US
Practice Address - Phone:305-922-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty