Provider Demographics
NPI:1518535053
Name:BASS, CATHERINE (LISW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BASS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-1101
Mailing Address - Country:US
Mailing Address - Phone:563-279-4682
Mailing Address - Fax:
Practice Address - Street 1:2435 KIMBERLY RD STE 270
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3509
Practice Address - Country:US
Practice Address - Phone:563-219-7700
Practice Address - Fax:563-396-2060
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL150.106722OtherLSW
IA111306OtherLISW