MEDICARE: BLISSFUL PATH THERAPY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1205568755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLISSFUL PATH THERAPY SERVICES

Provider Business Mailing Address
First Line	:	666 CHASE RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-3612
Country	:	US
Telephone Number	:	561-337-1227
Fax Number	:

Provider Business Practice Location Address
First Line	:	666 CHASE RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-3612
Country	:	US
Telephone Number	:	561-291-8865
Fax Number	:

Authorized Official
Title or Position	:	OWNER OF ENTITY
Name	:	KARIE A BLISS
Credential	:	MED., LMHC
Telephone Number	:	561-337-1227

Provider Enumeration Date	:	06/24/2022
Last Update Date	:	11/23/2022

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