| Bliss Psychiatry, Llc | |
|
309 Court Ave Ste 846 Des Moines IA 50309-2245 | |
| (515) 441-7944 | |
| (833) 417-4737 |
| Full Name | Bliss Psychiatry, Llc |
|---|---|
| Speciality | Counselor |
| Location | 309 Court Ave Ste 846, Des Moines, Iowa |
| Authorized Official Name and Position | Elizabeth A Brake (AGENT) |
| Authorized Official Contact | 5154417944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bliss Psychiatry, Llc 800 4th Ave # 1009 Grinnell IA 50112-2041 Ph: (515) 441-7944 | Bliss Psychiatry, Llc 309 Court Ave Ste 846 Des Moines IA 50309-2245 Ph: (515) 441-7944 |
| NPI Number | 1073277653 |
|---|---|
| Provider Enumeration Date | 10/28/2021 |
| Last Update Date | 08/22/2022 |
| Certification Date | 08/22/2022 |
| Medicare PECOS PAC ID | 3476940024 |
|---|---|
| Medicare Enrollment ID | O20220428001913 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073277653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Travis J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306250279 PECOS PAC ID: 9436451523 Enrollment ID: I20160106001880 |
| Provider Name | Elizebeth Brake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952993354 PECOS PAC ID: 8224430426 Enrollment ID: I20220428001967 |
| Provider Name | Rosaline During |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699476119 PECOS PAC ID: 4880059823 Enrollment ID: I20230427000354 |
| Provider Name | Shameka Logan Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972215382 PECOS PAC ID: 9032574918 Enrollment ID: I20230921002420 |
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