Claripath Psychiatry PLLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Anna, IL

NPI 1265317523 · NPPES record last updated Aug 7, 2025

Key facts

NPI
1265317523
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
CLARIPATH PSYCHIATRY PLLC
Practice address
330 S Main St
Anna, IL 62906-1242
Phone
(618) 270-7879
Fax
(949) 864-3553
NPI assigned
Aug 7, 2025
Organization subpart
No

Authorized official

Name
Mr. Keith Samuel Bass, PMHNP-BC
Title
Owner/Provider
Phone
(618) 270-7879

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20251126000229 IL Part B Supplier - Clinic/Group Practice 1759873789 Receives reassigned benefits from 1 practitioner
Practice locations: Anna, IL

National Provider Directory

Locations

330 S Main St
Anna, IL 62906
Phone (618) 270-7879

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

330 S Main St
Anna, IL 62906-1242

Mailing address

2501 Chatham Rd # 4358
Springfield, IL 62704-4188
Phone (618) 270-7879

Other providers in Anna, IL

All providers in Anna, IL · Psychiatric/Mental Health Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.