Provider Demographics
NPI:1447692132
Name:BAS, NATALIA J (LMHC, LPC)
Entity type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:J
Last Name:BAS
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:MRS
Other - First Name:NATALIA
Other - Middle Name:J
Other - Last Name:GRANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, LPC
Mailing Address - Street 1:8387 BOCA RIO DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433
Mailing Address - Country:US
Mailing Address - Phone:248-761-6529
Mailing Address - Fax:954-227-2704
Practice Address - Street 1:8387 BOCA RIO DRIVE
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433
Practice Address - Country:US
Practice Address - Phone:248-761-6529
Practice Address - Fax:954-227-2704
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18386101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health