Jerald Franklin Bass Jr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A16993 Issued in NC

Practice address

4070 Barrett Dr
Raleigh, NC 27609-6604

Phone

(919) 283-3137

NPI assigned

Sep 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1699445742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 BARRETT DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096604",
            "telephone_number": "919-283-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 BARRETT DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096604",
            "telephone_number": "919-283-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "JERALD",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@trinitasservices.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4070 Barrett Dr",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276096604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katrina Basore, CAA
• Adeyosola Bass
• Brian Edmond Bass, MD
• Candace Bass
• Cindy H Bass, FNP
• Kimberly A Bass, LPTA
• Maura Carter Bass, PA-C
• Olivia Brooke Bass
• Samuel Scott Bass, MS, MDIV, LMFT
• Theresa Bass, BS

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.