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General NPI Number Information
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NPI Number | 1386025161
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Entity Type | Organization
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Legal Business Name | SIMPLY LIVING BLESSED, LLC
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 9921 REISTERSTOWN RD STE 1D
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3900
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Country | US
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Telephone | 410-581-5057
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Fax | 410-581-5058
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Provider Business Mailing Address
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Address Line | 604 SHIRLEY MANOR RD
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City | REISTERSTOWN
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State | MD
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Zip | 21136-2319
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Country | US
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Telephone | 443-255-5408
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Fax | 410-581-5058
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Authorized Official
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Title or Position | CEO/THERAPIST
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Name | SHEILA BRYANT
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Credential | LCSW-C
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Telephone | 443-255-5408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15546
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15546
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License Number State | MD
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