Basshamdbt LLC
Organization Active NPI Clinical Social Worker · Birmingham, MI
NPI 1174280002 · NPPES record last updated Nov 28, 2021
Key facts
- NPI
- 1174280002
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- BASSHAMDBT LLC
- Practice address
- 200 Elm St Ste 200D
Birmingham, MI 48009-6322 - Phone
- (248) 986-2991
- Fax
- (248) 294-1237
- NPI assigned
- Nov 28, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- MYMENTALSPACE.ORG
Authorized official
- Name
- Mr. Kelly Michael Bassham, LMSW
- Title
- Ceo
- Phone
- (248) 986-2991
Practitioners 1
-
Kelly Michael Bassham, LMSW
National Provider Directory
- Part of
- Basshamdbt LLC
Locations
200 Elm St
Ste 200D
Birmingham, MI 48009
Phone (248) 986-2991
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
200 Elm St Ste 200D
Birmingham, MI 48009-6322
Mailing address
200 Elm St Ste 200D
Birmingham, MI 48009-6322
Phone (248) 986-2991
Other names
- mymentalspace.org
Other providers in Birmingham, MI
- Elizabeth Barone
- Christine Mary Barron
- Erica Barry
- Reilly Barth
- Kelly Michael Bassham
- Renea Rishmawi Bayouk
- Be Well Lifestyle Centers Mi Inc
- Be Well of Birmingham PLLC
- Joseph A Beals
- Carolyn Beauvais
All providers in Birmingham, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2021. 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.