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General NPI Number Information
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NPI Number | 1265659932
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Entity Type | Individual
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Provider Name | KENT ALAN BASS LPC
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Gender | Male
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1601 E LAMAR BLVD SUITE 200
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City | ARLINGTON
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State | TX
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Zip | 76011-4510
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Country | US
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Telephone | 817-265-2328
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Fax |
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Provider Business Mailing Address
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Address Line | 3414 ARCHWAY CT
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City | ARLINGTON
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State | TX
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Zip | 76016-2304
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Country | US
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Telephone | 817-446-8548
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 14807
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License Number State | TX
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