Individual provider Active NPI

Leslie C Bass, M.A., L.M.H.C.

  • Mental Health Counselor
  • Bradenton, FL
National Provider Identifier
1053630269
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 4399 Issued in FL
Practice address
5460 Lena Rd
Suite 103
Bradenton, FL 34211-9500
Phone
(941) 907-0525
Fax
(941) 462-2968
NPI assigned
May 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 4399 FL Primary

Addresses

Primary practice location

5460 Lena Rd
Suite 103
Bradenton, FL 34211-9500

Mailing address

5460 Lena Rd
Suite 103
Bradenton, FL 34211-9500
Phone (941) 907-0525

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MH 4399FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor Q Inc PastSince Oct 6, 2013 Accepting new patients
Theresa a Benedict LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1053630269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 LENA RD",
            "address_2": "SUITE 103",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119500",
            "telephone_number": "941-907-0525",
            "fax_number": "941-462-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 LENA RD",
            "address_2": "SUITE 103",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119500",
            "telephone_number": "941-907-0525",
            "fax_number": "941-462-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "LESLIE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "M.A., L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 4399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.