Kristy Bassett, LSW
Individual provider Active NPI Social Worker · Hines, IL
NPI 1154836823 · NPPES record last updated May 18, 2018
Key facts
- NPI
- 1154836823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 150.102184 (IL)
- Practice address
- 5000 S 5TH Ave BLDG 2284N
Hines, IL 60141 - Phone
- (708) 202-4965
- NPI assigned
- Dec 4, 2017
- Sex
- Female
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 150.102184 | IL | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.102184 | IL | Yes |
Addresses
Primary practice location
5000 S 5TH Ave BLDG 2284N
Hines, IL 60141
Mailing address
5000 S 5TH Ave BLDG 2284N
Hines, IL 60141-3030
Phone (708) 202-4965
Other providers in Hines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.