Individual provider Active NPI

Kiyana Bass

  • Clinical Social Worker
  • Marlton, NJ
National Provider Identifier
1609366848
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06124000 Issued in NJ
Practice address
1 Eves Dr Ste 111
Marlton, NJ 08053-3125
Phone
(908) 333-8513
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW019536 PA
Clinical Social Worker 1041C0700X 44SC06124000 NJ Primary
Clinical Social Worker 1041C0700X TPSW2264 FL

Addresses

Primary practice location

1 Eves Dr Ste 111
Marlton, NJ 08053-3125

Mailing address

1000 Northbrook Dr
Trevose, PA 19053-8430
Phone (267) 563-8795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180730001399 PA Practitioner - Clinical Social Worker 3375891989 Reassigns benefits to 1 organization
Practice locations: Philadelphia, PA
I20241015002369 NJ Practitioner - Clinical Social Worker 3375891989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Northbrook Dr
Suite 510
Trevose, PA 19053-8430
Phone (267) 563-8795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPSW2264FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rla Assessment and Consultation LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1609366848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NORTHBROOK DR",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190538430",
            "telephone_number": "267-563-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EVES DR STE 111",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533125",
            "telephone_number": "908-333-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "KIYANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019536",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06124000",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "TPSW2264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.