Bass, Kelly Joe

Bass, Kelly Joe is an individual health care provider with primary practice located at 705 E 41St Street Suite 100, Sioux Falls SD 57105-6047. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Bass, Kelly Joe can be contacted via phone (605) 357-0121.

Contact Information

Primary practice address
705 E 41St Street Suite 100 Sioux Falls SD 57105-6047
Phone: (605) 357-0121
Fax: (605) 357-0190
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X CSWPIP1983 South Dakota

Profile Details

NPI number 1407939929
LBN Legal business name Bass, Kelly Joe
Credentials CSWPIP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407939929 NPPES
South Dakota MEDICAID 6571380

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