Daric Deshawn Bass Sr., LMT, CPT, CES.
Individual provider Active NPI Massage Therapist · 126 Belleauwood Circle, Belle Chasse, la, LA
NPI 1376137018 · NPPES record last updated Feb 23, 2021
Key facts
- NPI
- 1376137018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- LA7594 (LA)
- Practice address
- 126 Belleauwood Circle
126 Belleauwood Circle, Belle Chasse, la, LA 70037 - Phone
- (504) 228-9137
- NPI assigned
- Feb 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| LA7594 | LA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | LA7594 | LA | Yes |
Addresses
Primary practice location
126 Belleauwood Circle
126 Belleauwood Circle, Belle Chasse, la, LA 70037
Mailing address
671 Rosa Ave Ste 211
Metairie, LA 70005-2831
Phone (504) 355-6550
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 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.