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Organization
BASS NURSE PRACTITIONERS IN PSYCHIATRY PLLC
Active
Organization
BASS NURSE PRACTITIONERS IN PSYCHIATRY PLLC
Active
Other names
Bass Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN SHAW NP-P, PMHNP-BC (MANAGING MEMBER)
(917) 575-5662
Entity
Organization
Contact information
Practice address
641 LEXINGTON AVE FL 14, NEW YORK, NY 10022-4503
(917) 923-0569
(469) 414-5292
Mailing address
641 LEXINGTON AVE FL 14, NEW YORK, NY 10022-4503
(917) 923-0569
(469) 414-5292
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/08/2026
Last updated
07/08/2026
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