Provider Demographics
NPI:1023501160
Name:BASS, ERICA LEE (LPCC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LEE
Last Name:BASS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 N HIGH ST STE 402D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3253
Mailing Address - Country:US
Mailing Address - Phone:614-333-8138
Mailing Address - Fax:
Practice Address - Street 1:4041 N HIGH ST STE 402D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3253
Practice Address - Country:US
Practice Address - Phone:614-333-8138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700723-TRNE101YM0800X
OHE.2203055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health