Gary Bass, LPC

Individual provider Active NPI Professional Counselor · Staunton, VA

NPI 1053564930 · NPPES record last updated Oct 23, 2008

Key facts

NPI
1053564930
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0701004465 (VA)
Practice address
85 Sangers LN
Staunton, VA 24401-6712
Phone
(540) 887-3200
Fax
(540) 887-3240
NPI assigned
Oct 23, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0701004465VAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701004465 VA Yes

Addresses

Primary practice location

85 Sangers LN
Staunton, VA 24401-6712

Mailing address

85 Sangers LN
Staunton, VA 24401-6712
Phone (540) 887-3200

Other identifiers

IdentifierTypeStateIssuer
004945336MedicaidVA

Other providers in Staunton, VA

All providers in Staunton, VA · Professional Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.