Provider Demographics
NPI:1740043835
Name:SHANTI BLISS WELLNESS, LLC
Entity type:Organization
Organization Name:SHANTI BLISS WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LICENSED PROFESSIONAL COUNSE
Authorized Official - Prefix:
Authorized Official - First Name:ARTI
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAHARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:610-943-1348
Mailing Address - Street 1:2138 W UNION BLVD STE 1068
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1275 GLENLIVET DR STE 100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-3107
Practice Address - Country:US
Practice Address - Phone:610-943-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)