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General NPI Number Information
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NPI Number | 1730222803
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Entity Type | Individual
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Provider Name | KIRK E. BASS LPC, LADC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 91 WEST ST
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City | DANBURY
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State | CT
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Zip | 06810-6529
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Country | US
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Telephone | 203-748-2936
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Fax | 203-797-8568
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Provider Business Mailing Address
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Address Line | 928 MARION AVE
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City | PLANTSVILLE
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State | CT
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Zip | 06479-1225
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Country | US
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Telephone | 203-748-2936
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Fax | 203-797-8568
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 000021
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000612
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License Number State | CT
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