MEDICARE: FELICIA BASS BCBA, LBA

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	106E00000X	Assistant Behavior Analyst
2	103K00000X	Behavior Analyst	1-24-76530	AL

General Provider Information

NPI Number	:	1477172591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA BASS BCBA, LBA

Provider Business Mailing Address
First Line	:	1286 OAK GROVE RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6929
Country	:	US
Telephone Number	:	205-201-1716
Fax Number	:

Provider Business Practice Location Address
First Line	:	1286 OAK GROVE RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6929
Country	:	US
Telephone Number	:	205-201-1716
Fax Number	:

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

Provider Enumeration Date	:	04/09/2020
Last Update Date	:	01/23/2025

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