Bass, Cp Kelly
Bass, Cp Kelly is an sole proprietor health care provider with primary practice located at 1129 E Main St 305, Wailuku HI 96793-2053. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bass, Cp Kelly can be contacted via phone (808) 242-7011.Contact Information
Primary practice address
1129 E Main St 305
Wailuku HI 96793-2053
Phone: (808) 242-7011
Fax: (808) 244-9010
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 292 | Hawaii |
Profile Details
| NPI number | 1457423352 |
|---|---|
| LBN Legal business name | Bass, Cp Kelly |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Dec 5th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457423352 | NPPES |
| Hawaii | Other | 000077 | HMAA |
| Hawaii | MEDICAID | 01542101 | HMAA |
| Hawaii | Other | H0000TCBHB | HMAA |
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