=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427925288
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BASS PSYCHIATRY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/17/2025
-----------------------------------------------------
Last Update Date | 10/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 N 7TH ST STE 201
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40202-3916
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-602-4195
-----------------------------------------------------
Fax | 502-842-4358
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 N 7TH ST STE 201
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40202-3916
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-602-4195
-----------------------------------------------------
Fax | 502-842-4358
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | APRN, PMHNP
-----------------------------------------------------
Name | DANIELLE BASS
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 502-602-4195
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------