| Blysss Behavioral Health, PLLC | |
|
9415 S Western Ave # 206 Chicago IL 60643-6700 | |
| (708) 941-7448 | |
| Not Available |
| Full Name | Blysss Behavioral Health, PLLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 9415 S Western Ave # 206, Chicago, Illinois |
| Authorized Official Name and Position | Cory R Willliams (MANAGING PARTNER) |
| Authorized Official Contact | 8444259777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blysss Behavioral Health, PLLC 900 W Sunset Dr Apt 613 Glenwood IL 60425-1159 Ph: (844) 425-9777 | Blysss Behavioral Health, PLLC 9415 S Western Ave # 206 Chicago IL 60643-6700 Ph: (708) 941-7448 |
| NPI Number | 1932945243 |
|---|---|
| Provider Enumeration Date | 07/05/2024 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Medicare PECOS PAC ID | 2062941867 |
|---|---|
| Medicare Enrollment ID | O20250123001966 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932945243 | NPI | - | NPPES |
| Provider Name | Cayce R Mcconnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013339498 PECOS PAC ID: 7719213271 Enrollment ID: I20190723000639 |
| Provider Name | Michelle Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487392031 PECOS PAC ID: 1153765177 Enrollment ID: I20240219000939 |
| Provider Name | Cory Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770125908 PECOS PAC ID: 4587092127 Enrollment ID: I20240401001128 |
| Provider Name | Sierra N Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598413304 PECOS PAC ID: 7113305871 Enrollment ID: I20260319003671 |
| Provider Name | Anayelit Alcaide |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184487951 PECOS PAC ID: 5991278798 Enrollment ID: I20260623004832 |
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