Provider Demographics
NPI:1902246994
Name:BASS, CARMEA A
Entity Type:Individual
Prefix:
First Name:CARMEA
Middle Name:A
Last Name:BASS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 LAVENDER BREEZE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6848
Mailing Address - Country:US
Mailing Address - Phone:702-476-2777
Mailing Address - Fax:702-848-2402
Practice Address - Street 1:5920 LAVENDER BREEZE ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-6848
Practice Address - Country:US
Practice Address - Phone:702-475-6555
Practice Address - Fax:702-848-2402
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst