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Organization

BASS COUNSELING SERVICES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MACHELLE OUTLAW BASS LPC (PRESIDENT)
(919) 658-7500
Entity
Organization

Contact information

Practice address
1010 N BREAZEALE AVE, MOUNT OLIVE, NC 28365-1106
(919) 658-7500
(919) 658-7509
Mailing address
PO BOX 427, MOUNT OLIVE, NC 28365-0427
(919) 658-7500
(919) 658-7509

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3563
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6006374
NC
Enumeration date
03/21/2008
Last updated
03/24/2015
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