Provider Demographics
NPI:1750559795
Name:BASKIND, BETTY (LCSW)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:BASKIND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4283 PIEDMONT AVE
Mailing Address - Street 2:SUITE E-1
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4758
Mailing Address - Country:US
Mailing Address - Phone:510-496-6041
Mailing Address - Fax:
Practice Address - Street 1:4283 PIEDMONT AVE STE E1
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4761
Practice Address - Country:US
Practice Address - Phone:510-496-6041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS5965101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health