Provider Demographics
NPI:1831814615
Name:CYNTHIA BASSETT PSYCHOTHERAPY
Entity type:Organization
Organization Name:CYNTHIA BASSETT PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:LLP LPC
Authorized Official - Phone:269-345-5130
Mailing Address - Street 1:1443 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1849
Mailing Address - Country:US
Mailing Address - Phone:269-345-5130
Mailing Address - Fax:269-375-6078
Practice Address - Street 1:1443 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1849
Practice Address - Country:US
Practice Address - Phone:269-345-5130
Practice Address - Fax:269-375-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty