ETHAN BLISS (NPI# 1851428460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851428460 |
Entity Type | Individual |
Full Name | ETHAN BLISS |
Credential | PHD |
Practice Address |
340 Park Ave Frederick MD 21701-4931 |
Mailing Address |
121 Manda Dr Middletown MD 21769-7853 |
Practice Telephone | 3016631683 |
Practice Fax Number | 3016633792 |
Mailing Telephone | 3015080102 |
Enumeration Date | 2007-02-28 |
Last Update Date | 2010-11-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
MH 7447 | FL | Behavioral Health & Social Service Providers |
N | 101YM0800X |
Counselor Specialization: Mental Health |
39001937A | IN | Behavioral Health & Social Service Providers |
N | 103T00000X | Psychologist | 20042437A | IN | Behavioral Health & Social Service Providers |
Y | 103TC0700X |
Psychologist Specialization: Clinical |
04888 | MD | Behavioral Health & Social Service Providers |
Street Address |
340 PARK AVE |
City | FREDERICK |
State | MD |
Zip Code | 21701-4931 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801968797 | Fred I Wolfson | Acupuncturist | 340 Park Ave, Frederick, MD 21701-4931 | 2006-11-15 |
1689062663 | Autumn Brennan | Counselor | 340 Park Ave, Frederick, MD 21701-4931 | 2014-12-29 |
1871995811 | John Gilbert | Social Worker | 340 Park Ave, Frederick, MD 21701-4931 | 2014-09-22 |
1831524925 | Tamara Yamour | Counselor | 340 Park Ave, Frederick, MD 21701-4931 | 2013-09-07 |
1871880518 | Justin C Barrick | Counselor | 340 Park Ave, Frederick, MD 21701-4931 | 2011-07-01 |
1538203773 | Raymond Richard Rother | Social Worker | 340 Park Ave, Frederick, MD 21701-4931 | 2007-02-19 |
1508903816 | Kevin David Graditor | Social Worker | 340 Park Ave, Frederick, MD 21701-4931 | 2007-01-30 |
1609921147 | Carol T. Miller | Registered Nurse | 340 Park Ave, Frederick, MD 21701-4931 | 2007-01-24 |
1407905060 | Susan B. Spangler | Social Worker | 340 Park Ave, Frederick, MD 21701-4931 | 2007-01-10 |
1841349479 | Ted Cmarada | Social Worker | 340 Park Ave, Frederick, MD 21701-4931 | 2007-01-10 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225670045 | Alana Earp | Social Worker | 810 Toll House Avenue, Frederick, MD 21701 | 2019-10-14 |
1851866065 | Main Place Treatment Centers LLC. | Clinic/Center | 127 S. Smallwood Street, Frederick, MD 21701 | 2018-10-04 |
1649775933 | Old Fashion Medicine, Inc | Internal Medicine | 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 | 2018-03-28 |
1063917938 | Kristin Deely | Nurse Practitioner | 400 West 7th Street, Cardiac Cath Lab 2nd Floor, Frederick, MD 21701 | 2018-03-24 |
1689180119 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 300 B Scholls Lane, Frederick, MD 21701 | 2017-12-20 |
1326590068 | Natalie Reid | Nurse Practitioner | 9093 Ridgefield Dr Ste 104, Frederick, MD 21701 | 2016-10-28 |
1649727967 | Scl Corpration | In Home Supportive Care | 550 Highland Street, Suite 110, Frederick, MD 21701 | 2016-09-02 |
1891159661 | Wellave, LLC | Clinic/Center | 411 Aviation Way Ste 245, Frederick, MD 21701 | 2016-04-07 |
1144694969 | Leslee Bry | Counselor | 120 W Church St Ste 3b, Frederick, MD 21701 | 2015-11-17 |
1851797732 | Frederick Dental | Dentist | 401 W 7th Street, Frederick Dental, Frederick, MD 21701 | 2014-11-05 |
Find all providers in zip 21701 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053756908 | Shouh-rong Vivian Tsai | Psychologist | 5301 Buckeystown Pike Ste 440, Frederick, MD 21704-8319 | 2013-05-06 |
1386876811 | Monica Kristine Pentony | Psychologist | 10142 Hansonville Rd, Frederick, MD 21702-1919 | 2009-08-18 |
1205002029 | Helene G Brenner | Psychologist | 97 S Mccain Dr, Ste. B, Frederick, MD 21703-6055 | 2008-05-01 |
1194906180 | Elise G. Abromson | Psychologist | 620 W Patrick St, Frederick, MD 21701-4028 | 2007-11-18 |
1316146566 | Maryland Counseling Centers, Inc. | Psychologist | 5300 Westview Dr., Bldg. 100, Suite 104, Frederick, MD 21703-8327 | 2007-07-17 |
1710193156 | Margaret Rose Bowman | Psychologist | 1497 Dogwood Dr, Frederick, MD 21701-4487 | 2007-05-15 |
1316163090 | John Patrick Farrell | Psychologist | 97b S Mccain Dr, Frederick, MD 21703-6055 | 2007-04-18 |
1396877189 | Health and Happiness LLC | Psychologist | 93 S Mccain Drive, Frederick, MD 21703 | 2007-03-09 |
1649363037 | Brenda Ann Vidal | Psychologist | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2006-09-30 |
1487766788 | Jennifer L Carter | Psychologist | 97 S Mccain Dr # B, Frederick, MD 21703-6055 | 2006-08-31 |
Find all providers in FREDERICK |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.