Provider Demographics
NPI:1639759665
Name:KAROL BASEL PLLC
Entity Type:Organization
Organization Name:KAROL BASEL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAROL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BASEL
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, NCSP
Authorized Official - Phone:520-261-3134
Mailing Address - Street 1:2893 E. SIERRA VISTA RD.
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716
Mailing Address - Country:US
Mailing Address - Phone:520-261-3134
Mailing Address - Fax:
Practice Address - Street 1:2893 E. SIERRA VISTA RD.
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716
Practice Address - Country:US
Practice Address - Phone:520-261-3134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAROL BASEL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty