Regina Bass

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6451018734

Practice address

3301 S Creek Dr SE Apt 204
Kentwood, MI 49512-8335

Phone

(313) 960-3759

NPI assigned

Apr 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Journey PLLC

  • Psychologist
  • Grand Rapids, MI
  • NPI 1538531017
  NPD
• Ottawa County CMH

  • Community/Behavioral Health Agency
  • Grand Haven, MI
  • NPI 1346329570
  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1245763879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 EASTCASTLE DR SE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495088873",
            "telephone_number": "616-888-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 S CREEK DR SE APT 204",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495128335",
            "telephone_number": "313-960-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "REGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6451018734",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FM",
            "license": "6451018734",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "6451018734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leon James Bangma, OD
• Chris Barber
• Annaliese Barnhart, PA
• Jennifer Kay Barone, FNP
• Erin Rebecca Barrett, PA-C
• Taylor Bateman
• Parlee Bates
• Adeline Bauer, OD
• Rajendra D Bavada, R.PH
• Baymark of Michigan, Inc.

• Mental Health Counselor in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.