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General NPI Number Information
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NPI Number | 1407377146
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Entity Type | Organization
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Legal Business Name | INNER BLISS COUNSELING, LLC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 07/03/2017
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Provider Practice Location Address
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Address Line | 1324 BELMONT AVE STE 102
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City | SALISBURY
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State | MD
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Zip | 21804-4543
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Country | US
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Telephone | 443-365-7753
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Fax |
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Provider Business Mailing Address
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Address Line | 35813 BOB KELLY RD
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City | PITTSVILLE
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State | MD
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Zip | 21850-2075
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Country | US
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Telephone | 443-235-2456
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD HELPER
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Name | LAURA BRADFORD
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Credential | LCSW-C
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Telephone | 443-235-2456
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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 | 15367
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License Number State | MD
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