Provider Demographics
NPI:1134331184
Name:STUART W. BASSMAN, ED.D., INC.
Entity Type:Organization
Organization Name:STUART W. BASSMAN, ED.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:W
Authorized Official - Last Name:BASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:513-651-4365
Mailing Address - Street 1:1955 MEARS AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-1980
Mailing Address - Country:US
Mailing Address - Phone:513-624-8188
Mailing Address - Fax:513-231-2917
Practice Address - Street 1:21 E MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1711
Practice Address - Country:US
Practice Address - Phone:513-651-4365
Practice Address - Fax:513-231-2917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3495103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty