Individual provider Active NPI

Latoria R Bass, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1497064760
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65899 Issued in TX
Practice address
444 W Fort St FL 2
Boise, ID 83702-4535
Phone
(208) 422-1018
NPI assigned
Oct 4, 2010
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 088046 NY
Clinical Social Worker 1041C0700X 65899 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

444 W Fort St FL 2
Boise, ID 83702-4535

Mailing address

2411 Anita St
Houston, TX 77004-3101
Phone (504) 427-7005

Other practice location 1

2411 Anita St
Houston, TX 77004-3101
Phone (504) 427-7005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
088046NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1497064760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 ANITA ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770043101",
            "telephone_number": "504-427-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W FORT ST FL 2",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024535",
            "telephone_number": "208-422-1018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2411 Anita St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770043101",
            "country_code": "US",
            "telephone_number": "504-427-7005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASS",
        "first_name": "LATORIA",
        "middle_name": "R",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "088046",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65899",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.