Individual provider Active NPI

Corrie Blissit, AMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1679290431
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
134822 Issued in CA
Practice address
840 N la Fayette Park PL Apt B
Los Angeles, CA 90026-2920
Phone
(803) 507-4606
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 134822 CA Primary

Addresses

Primary practice location

840 N la Fayette Park PL Apt B
Los Angeles, CA 90026-2920

Mailing address

840 N la Fayette Park PL Apt B
Los Angeles, CA 90026-2920
Phone (803) 507-4606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 16, 2026 through Jan 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1679290431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 N LA FAYETTE PARK PL APT B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262920",
            "telephone_number": "803-507-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N LA FAYETTE PARK PL APT B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262920",
            "telephone_number": "803-507-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISSIT",
        "first_name": "CORRIE",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "134822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.