Individual provider Active NPI

Lucinda Jane Bassili, L.C.S.W.

  • Clinical Social Worker
  • Carrollton, TX
National Provider Identifier
1912094327
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19671 Issued in TX
Practice address
1713 Ridge Rd
Carrollton, TX 75006-3901
Phone
(469) 546-5360
Fax
(469) 375-2482
NPI assigned
Oct 6, 2006
Last updated
Jun 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19671 TX Primary

Addresses

Primary practice location

1713 Ridge Rd
Carrollton, TX 75006-3901

Mailing address

1713 Ridge Rd
Carrollton, TX 75006-3901
Phone (469) 546-5360

Other identifiers 2

IdentifierTypeStateIssuer
188190769OtherTXGROUP PTAN: TXB139015
1912094327OtherTXINDIVIDUAL PTAN: TXB139016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000307 TX Practitioner - Clinical Social Worker 2062504376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Assurasource LTDGroup PAC ID 8123125580, 61 clinicians

Practice addresses (Care Compare)

400 N Allen Dr
Allen, TX 75013-2568
Phone (972) 233-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19671TXMDGeneral Practice Dentistry

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1912094327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 RIDGE RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750063901",
            "telephone_number": "469-546-5360",
            "fax_number": "469-375-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 RIDGE RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750063901",
            "telephone_number": "469-546-5360",
            "fax_number": "469-375-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSILI",
        "first_name": "LUCINDA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "19671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN:  TXB139015",
            "identifier": "188190769",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN:  TXB139016",
            "identifier": "1912094327",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.