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Organization

CLARIPATH PSYCHIATRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEITH SAMUEL BASS PMHNP-BC (OWNER/PROVIDER)
(618) 270-7879
Entity
Organization

Contact information

Practice address
330 S MAIN ST, ANNA, IL 62906-1242
(618) 270-7879
(949) 864-3553
Mailing address
2501 CHATHAM RD # 4358, SPRINGFIELD, IL 62704-4188
(618) 270-7879
(949) 864-3553

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
08/07/2025
Last updated
08/07/2025
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