Provider Demographics
NPI:1891121968
Name:BLISS PSYCHOTHERAPY & CONSULTING LLC
Entity Type:Organization
Organization Name:BLISS PSYCHOTHERAPY & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DELAINE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-583-5335
Mailing Address - Street 1:349 KELLER PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2266
Mailing Address - Country:US
Mailing Address - Phone:817-382-2249
Mailing Address - Fax:817-541-4483
Practice Address - Street 1:349 KELLER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2266
Practice Address - Country:US
Practice Address - Phone:817-382-2249
Practice Address - Fax:817-541-4483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99230501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty