MEDICARE: BETTY B. BASS

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

General Provider Information

NPI Number	:	1417839473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY B. BASS

Provider Business Mailing Address
First Line	:	11014 CHILDS ST
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4411
Country	:	US
Telephone Number	:	301-755-4252
Fax Number	:

Provider Business Practice Location Address
First Line	:	1763 COLUMBIA RD NW STE 100
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-2834
Country	:	US
Telephone Number	:	301-755-4252
Fax Number	:

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

Provider Enumeration Date	:	07/22/2025
Last Update Date	:	07/22/2025

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Directions to “ BETTY B. BASS ” Practice Location

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