Healthcare Provider Details

I. General information

NPI: 1972418861
Provider Name (Legal Business Name): REBECCA BASCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 MCCORMICK RD STE 800
HUNT VALLEY MD
21031-1002
US

IV. Provider business mailing address

5709 BIRCHWOOD AVE
BALTIMORE MD
21214-1703
US

V. Phone/Fax

Practice location:
  • Phone: 410-800-2169
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: