NPIMap

Organization Active NPI

The Center for Integrative Healthcare, LLC

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1952434730
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
THE CENTER FOR INTEGRATIVE HEALTHCARE, LLC
Practice address
247 W. Patrick St
Frederick, MD 21701
Phone
(301) 663-1683
Fax
(301) 663-3792
NPI assigned
Mar 13, 2007
Last updated
Jul 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Authorized official

Name
Ethan L Bliss, PHDNPI 1851428460
Title
Owner/Social Work Clinical
Phone
(301) 508-0102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

247 W. Patrick St
Frederick, MD 21701

Mailing address

247 W. Patrick St
Frederick, MD 21701
Phone (301) 663-1683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080918000544 MD Part B Supplier - Clinic/Group Practice 7517974256 Receives reassigned benefits from 2 practitioners
Practice locations: Frederick, MD

National Provider Directory

National Provider Directory

Locations

247 W Patrick St
Frederick, MD 21701
Phone (301) 663-1683

340 Park Ave
Frederick, MD 21701
Phone (301) 663-1683

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1952434730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 W. PATRICK ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "301-663-1683",
            "fax_number": "301-663-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 W. PATRICK ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "301-663-1683",
            "fax_number": "301-663-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR INTEGRATIVE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "BLISS",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/SOCIAL WORK CLINICAL",
        "authorized_official_telephone_number": "301-508-0102",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.