Healthcare Provider Details

I. General information

NPI: 1447692132
Provider Name (Legal Business Name): NATALIA J BAS LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIA J GRANDA LMHC, LPC

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 02/14/2025
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8387 BOCA RIO DRIVE
BOCA RATON FL
33433
US

IV. Provider business mailing address

8387 BOCA RIO DRIVE
BOCA RATON FL
33433
US

V. Phone/Fax

Practice location:
  • Phone: 248-761-6529
  • Fax: 954-227-2704
Mailing address:
  • Phone: 248-761-6529
  • Fax: 954-227-2704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH18386
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: