Provider Demographics
NPI:1245052398
Name:BLISSFUL ROUTES THERAPY PLLC
Entity type:Organization
Organization Name:BLISSFUL ROUTES THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWADAMILOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONEHIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-875-6726
Mailing Address - Street 1:18400 CHERRY CREEK DR APT 207
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2919
Mailing Address - Country:US
Mailing Address - Phone:773-875-6726
Mailing Address - Fax:
Practice Address - Street 1:18400 CHERRY CREEK DR APT 207
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2919
Practice Address - Country:US
Practice Address - Phone:773-875-6726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty