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ETERNAL BLISS, LLC
NPI 1942883905
Community/Behavioral Health in Fort Worth, TX

Active since April 28, 2021
4500 MERCANTILE PLAZA DR STE 300, FORT WORTH, TX 76137(817) 476-0317 Get Directions Write a Review

NPPES record last updated: June 13, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 23, 2021, Jun 25, 2021, Apr 28, 2021 (3 updates tracked since 2021).

About Eternal Bliss, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETERNAL BLISS, LLC (NPI 1942883905) is a healthcare organization registered as a community/behavioral health in Fort Worth, Texas and active in the NPI registry since April 2021. The organization maintains a secondary practice location in Arlington and lists Laquindra Carroll, Owner, as its authorized official.

NPPES Registry Identity

NPI1942883905
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameETERNAL BLISS, LLC
Location Address4500 MERCANTILE PLAZA DR STE 300Fort Worth, TX 76137-4206
Mailing Address4204 Bent Oaks DrArlington, TX 76001-5157 · (817) 476-0317
Phone(817) 476-0317
Organization SubpartNo
Authorized OfficialLaquindra CarrollOwner · (817) 986-6159
Enumeration DateApril 28, 2021
Last NPPES UpdateJune 13, 20263 updates tracked since enumeration
NPPES CertifiedJune 13, 2026
✔ NPI 1942883905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
4500 MERCANTILE PLAZA DR STE 300, Fort Worth, TX 76137
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Secondary Practice Location 1

Location 11241 W Green Oaks BlvdArlington, TX 76013-8301 · Phone (817) 476-0317 · Fax (888) 333-8980

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eternal Bliss, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateTexasEnrollment IDO20211229001091Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Eternal Bliss, LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Laquindra Carroll, LCSW
Clinical Social Worker
NPI 1194316083
1241 W GREEN OAKS BLVD
Arlington, TX 76013
(817) 476-0317
✔ PECOS✔ Accepts Medicare10 mi
Joann Baly, LCSW
Clinical Social Worker
NPI 1174223754
3743 BRIDGEBLUFF LN
Katy, TX 77449
(281) 216-4586
✔ PECOS226 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eternal Bliss, LLC's NPI number?

The NPI number for Eternal Bliss, LLC is 1942883905. It was assigned to this organization in the NPPES registry on April 28, 2021.

Where is Eternal Bliss, LLC located?

Eternal Bliss, LLC is located at 4500 Mercantile Plaza Dr Ste 300, Fort Worth, TX 76137. The listed phone number is (817) 476-0317.

What is Eternal Bliss, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Eternal Bliss, LLC enrolled in Medicare?

Yes. Eternal Bliss, LLC is registered in the Medicare PECOS enrollment system.

When is Eternal Bliss, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Eternal Bliss, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Clinical Social Worker, reassign their Medicare billing to Eternal Bliss, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Eternal Bliss, LLC was last updated on June 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.