Healthcare Provider Details

I. General information

NPI: 1497687198
Provider Name (Legal Business Name): HAYLEI BASS BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 S MAPLE ST
RUSTON LA
71270-4119
US

IV. Provider business mailing address

131 S MAPLE ST
RUSTON LA
71270-4119
US

V. Phone/Fax

Practice location:
  • Phone: 318-497-8260
  • Fax:
Mailing address:
  • Phone: 318-497-8260
  • Fax: 318-497-8260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: