MEDICARE: WHITNEY BLISS LPC

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	101Y00000X	Counselor	67664	TX
2	101YM0800X	Mental Health Counselor	67664	TX
3	101YP2500X	Professional Counselor	67664	TX

General Provider Information

NPI Number	:	1588028989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY BLISS LPC

Provider Business Mailing Address
First Line	:	1205 N HWY 123 STE 103
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-7756
Country	:	US
Telephone Number	:	512-400-0174
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 N HWY 123 STE 103
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-7756
Country	:	US
Telephone Number	:	512-400-0174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	10/15/2024

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Directions to “ WHITNEY BLISS LPC” Practice Location

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