Individual provider Active NPI

Kirsten Amber Bliss, MSW, P-LCSW

  • Clinical Social Worker
  • High Point, NC
National Provider Identifier
1386898708
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P004214 Issued in NC
Practice address
1401 Long St
High Point, NC 27262-2541
Phone
(336) 889-6161
Fax
(336) 387-9167
NPI assigned
Nov 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P004214 NC Primary

Addresses

Primary practice location

1401 Long St
High Point, NC 27262-2541

Mailing address

902 Bonner Dr
Jamestown, NC 27282-8948
Phone (336) 889-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P004214NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1386898708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BONNER DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828948",
            "telephone_number": "336-889-6161",
            "fax_number": "336-387-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 LONG ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272622541",
            "telephone_number": "336-889-6161",
            "fax_number": "336-387-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISS",
        "first_name": "KIRSTEN",
        "middle_name": "AMBER",
        "name_prefix": "Ms.",
        "credential": "MSW, P-LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-12",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P004214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.