Bass, Mandy
Bass, Mandy is an sole proprietor health care provider with primary practice located at 14411 Justice Rd Ste B , Midlothian VA 23113-6907. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Bass, Mandy can be contacted via phone (434) 962-9730.Contact Information
Primary practice address
14411 Justice Rd Ste B
Midlothian VA 23113-6907
Phone: (434) 962-9730
Fax: (276) 597-5158
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0701008636 | Virginia |
Profile Details
| NPI number | 1396386025 |
|---|---|
| LBN Legal business name | Bass, Mandy |
| Credentials | MA, LPC, NCC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 3rd, 2019 |
| Last updated | Nov 15th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396386025 | NPPES |
| Virginia | MEDICAID | 601448936 |
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