Healthcare Provider Details

I. General information

NPI: 1043187818
Provider Name (Legal Business Name): BLISS MIND MENTAL HEALTH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 SEMINOLA BLVD
CASSELBERRY FL
32707-3057
US

IV. Provider business mailing address

661 SEMINOLA BLVD
CASSELBERRY FL
32707-3057
US

V. Phone/Fax

Practice location:
  • Phone: 689-248-5317
  • Fax: 407-602-0954
Mailing address:
  • Phone: 689-248-5317
  • Fax: 407-602-0954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAREN BOVA
Title or Position: OWNER
Credential: APRN
Phone: 689-248-5317