Provider Demographics
NPI:1366887226
Name:BASFORD, VERA (LICSW)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:BASFORD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 MAIN ST STE 304
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3143
Mailing Address - Country:US
Mailing Address - Phone:415-218-6300
Mailing Address - Fax:
Practice Address - Street 1:182 MAIN ST STE 304
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3143
Practice Address - Country:US
Practice Address - Phone:415-218-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical