NPI 1245643964 · live from the CMS NPI Registry
Raelynn L. Bass, LPC
Counselor, Professional in Atlanta, GA. National Provider Identifier 1245643964, active.
NPI record
| NPI | 1245643964 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Professional 101YP2500X |
| Practice location | 881 Ponce De Leon Ave Ne, Suite #8, Atlanta, GA 30306 |
| Practice phone | 404-808-7919 |
| Enumerated | June 10, 2014 |
| Last updated | October 12, 2016 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | LPC008217 (GA) |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | LPC008217 (GA) |
| Marriage & Family Therapist | 106H00000X | LPC008217 (GA) |
| Counselor | 101Y00000X | LPC008217 (GA) |
| Counselor, Professional primary | 101YP2500X | LPC008217 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.