MEDICARE: MS. TRICIA BASSING LCSW, LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904003829	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	546001103002	OTHER	VA	TRICARE
2	188507	OTHER	VT	ANTHEM
3	298886	OTHER	VA	AMERIGROUP VIRGINIA, INC
4	A439	OTHER	VA	CARE FIRST BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295890028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRICIA BASSING LCSW, LICSW

Provider Business Mailing Address
First Line	:	4115 WISCONSIN AVE NW
Second Line	:	SUITE 203
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2812
Country	:	US
Telephone Number	:	202-244-0442
Fax Number	:

Provider Business Practice Location Address
First Line	:	4115 WISCONSIN AVE NW
Second Line	:	SUITE 203
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2812
Country	:	US
Telephone Number	:	202-244-0442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	06/13/2024

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