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General NPI Number Information
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NPI Number | 1164172185
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Entity Type | Organization
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Legal Business Name | BLISSFUL HEART, PLLC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 3104 SEMMES AVE
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City | RICHMOND
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State | VA
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Zip | 23225-3759
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Country | US
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Telephone | 804-531-4180
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Fax | 804-250-9960
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Provider Business Mailing Address
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Address Line | 3104 SEMMES AVE
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City | RICHMOND
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State | VA
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Zip | 23225-3759
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Country | US
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Telephone | 804-531-4180
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Fax | 804-250-9960
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Authorized Official
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Title or Position | OWNER/CEO
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Name | JACQUELINE BLISS BOONE
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Credential | NP
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Telephone | 804-847-0765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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