Provider Demographics
NPI:1265815831
Name:BASCH, JAMES D (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:BASCH
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 POST RD E
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5528
Mailing Address - Country:US
Mailing Address - Phone:203-955-1871
Mailing Address - Fax:
Practice Address - Street 1:1465 POST RD E
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5528
Practice Address - Country:US
Practice Address - Phone:203-955-1871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0013401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical