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Individual

MS. BOBBY BASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BOBBY BASS, L.C.S.W.

Contact information

Practice address
8 HILLSIDE AVE, SUITE 206, MONTCLAIR, NJ 07042-2129
(973) 819-3377
Mailing address
8 HILLSIDE AVE, SUITE 206, MONTCLAIR, NJ 07042-2129
(973) 819-3377

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
44SC04564300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
492298000
MAGELLAN BEHAVIORAL HEALTH OUT OF NETWORK PROVIDER
NJ
01
P3457598
OXFORD HEALTH PLAN OUT OF NETWORK PROVIDER
NJ
01
SC45643
NJ BOARD OF SOCIAL WORK
NJ
Enumeration date
02/18/2007
Last updated
06/17/2016
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