Lee Bascom LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2004031739 Issued in MO

Legal business name

LEE BASCOM LLC

Practice address

1121 Olivette Executive Pkwy
Suite 205
Saint Louis, MO 63132-3254

Phone

(314) 229-3483

NPI assigned

May 2, 2013

Organization subpart

No

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

Authorized official

Name

Lee Bascom, LCSW

Title

Owner/ LCSW

Phone

(314) 229-3483

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1295170363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 N KIRKWOOD RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631222639",
            "telephone_number": "314-229-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 OLIVETTE EXECUTIVE PKWY",
            "address_2": "SUITE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323254",
            "telephone_number": "314-229-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE BASCOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "BASCOM",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "OWNER/ LCSW",
        "authorized_official_telephone_number": "314-229-3483",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2004031739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500073730",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric D Lederman, M.D.
• Tawna Marie Ledesma, MED, LPC
• Amy Christine Ledioyt-Fuhr, RN
• Jennifer Lednick, RPH
• Martha Ledyard
• Lee S. Portnoff, M.D., P.C.
• Ivy Ann Desiree Lee Sharpe, RPH
• Aaron Yuntai Lee, MD
• Alayna Lee
• Alma Rasco Lee, RPH

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.