Individual
MRS. LADONNA K BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
1384 LIKHAW ROAD, LUMBERTON, NC 28358
(910) 737-4004
(910) 737-9650
Mailing address
324 GENTLE WINDS DR, SAINT PAULS, NC 28384-8955
(910) 374-0612
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
797
NC
101YM0800X
Mental Health Counselor
797
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111835
—
NC
Enumeration date
02/22/2008
Last updated
04/02/2012
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