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Basshamdbt LLC

Social Worker, Clinical in Birmingham, MI. Organization (NPI-2).

NPI number1174280002
StatusActive
Last updated in NPPESNov 28, 2021

Details

NPI
1174280002
Entity type
Organization (NPI-2)
Legal business name
Basshamdbt LLC
Organization subpart
Yes
Enumeration date
Nov 28, 2021
Certification date
Nov 28, 2021
Last updated
Nov 28, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical––Yes

Other names

  • Mymentalspace.Org (Other Name)

Practice location

200 Elm St Ste 200d
Birmingham, MI 48009-6322

Phone 248-986-2991 · Fax 248-294-1237

Mailing address

200 Elm St Ste 200d
Birmingham, MI 48009-6322

Phone 248-986-2991 · Fax 248-294-1237

Authorized official

Kelly Michael Bassham
Ceo
2489862991

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