Provider Demographics
NPI:1265062327
Name:BASSETT, DENISE (BA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:BASSETT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6104 N MISTY OAK TER
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465-2575
Mailing Address - Country:US
Mailing Address - Phone:352-897-5296
Mailing Address - Fax:
Practice Address - Street 1:6104 N MISTY OAK TER
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-2575
Practice Address - Country:US
Practice Address - Phone:352-897-5296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)