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SUSAN ROBIN BASS LPC
Professional >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1003469818
Individual Registrant: SUSAN ROBIN BASS LPC
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
27 MAIN ST HEBRON, CT 06248-1514 US
Tel: 860-228-1287 Fax: --
Tel: 860-228-1287 Fax: --
Contact information for business:
17 HERITAGE RD COLUMBIA, CT 06237-1047 US
Tel: 860-942-4924 Fax: --
Tel: 860-942-4924 Fax: --
Registration Information:
NPI: 1003469818
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor Professional | CT | 002008 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
