Provider Demographics
NPI:1265755961
Name:BLISS, GILBERT (LCSW-C)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:
Last Name:BLISS
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 YORK RD
Mailing Address - Street 2:SUITE 35
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6210
Mailing Address - Country:US
Mailing Address - Phone:410-296-2986
Mailing Address - Fax:410-296-2986
Practice Address - Street 1:1205 YORK RD
Practice Address - Street 2:SUITE 35
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6210
Practice Address - Country:US
Practice Address - Phone:410-296-2986
Practice Address - Fax:410-296-2986
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD155951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical