Provider Demographics
NPI:1043712912
Name:CREATIVE BLISS THERAPY
Entity type:Organization
Organization Name:CREATIVE BLISS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:316-395-1030
Mailing Address - Street 1:1646 E 2ND ST N STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4129
Mailing Address - Country:US
Mailing Address - Phone:316-395-1030
Mailing Address - Fax:316-330-6622
Practice Address - Street 1:1646 E 2ND ST N STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4129
Practice Address - Country:US
Practice Address - Phone:316-395-1030
Practice Address - Fax:316-330-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3032101YP2500X
KS45491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201198070BMedicaid