Individual
MRS. MANDY BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
14411 JUSTICE RD STE B, MIDLOTHIAN, VA 23113-6907
(434) 962-9730
(276) 597-5158
Mailing address
17000 OLD WESTRIDGE DR, MOSELEY, VA 23120-2340
(434) 962-9730
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701008636
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601448936
—
VA
Enumeration date
10/03/2019
Last updated
11/15/2023
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