Tina Chantelle Bass

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Rayville, LA

NPI 1962266601 · NPPES record last updated Feb 13, 2024

Key facts

NPI
1962266601
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CIT-5752 (LA)
Practice address
161 Comeaux Rd
Rayville, LA 71269-7554
Phone
(318) 303-5500
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CIT-5752LAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Second Chances Recovery Center LLC Current
since Feb 18, 2024
Accepting new patients

Locations

161 Comeaux Rd
Rayville, LA 71269
Phone (318) 303-5500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CIT-5752 LA Yes

Addresses

Primary practice location

161 Comeaux Rd
Rayville, LA 71269-7554

Mailing address

161 Comeaux Rd
Rayville, LA 71269-7554
Phone (318) 303-5500

Other providers in Rayville, LA

All providers in Rayville, LA · Addiction (Substance Use Disorder) Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.