BAST MARIE STACEY - NPI: 1578105367


Mood disorder is a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature. The classification is known as mood (affective) disorders in International Classification of Diseases (ICD).

NPI: 1578105367
Entity Type: Person: individual human being who furnishes health care.
Provider First Name: STACEY
Provider Last Name: BAST
Provider Middle Name: MARIE
Provider Gender Code: F
Provider Enumeration Date: 10/13/2019
Last Update Date: 10/13/2019

Business Address:

Provider First Line Business Mailing Address: 153 CHESTER ST
Provider Business Mailing Address City Name: CHESTER
Provider Business Mailing Address State Name: IL
Provider Business Mailing Address Postal Code: 62233
Provider Business Mailing Address Country Code (If outside U.S.): US
Phone: 6185593482

Mailing Address:

Provider First Line Business Practice Location Address: 223 GARDEN ST
Provider Business Practice Location Address City Name: EDWARDSVILLE
Provider Business Practice Location Address State Name: IL
Provider Business Practice Location Address Postal Code: 62025
Provider Business Practice Location Address Country Code (If outside U.S.): US
Phone: 3144209576

Primary Taxonomy:

Taxonomy Code: 164W00000X
License Number: 043-087181
License State: IL
Healthcare Provider Primary Taxonomy Switch: Y - The taxonomy is the primary taxonomy (there can be only one per NPI record
Type: Nursing Service Providers
Classification: Licensed Practical Nurse
Definition: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education
Taxonomy Description: experience
Source: The National Provider Identifier

Related NPI Codes

NPI Code Provider
1235117417 CHESTER CLINIC PROFESSIONAL CORP
1720053077 PLATT M STEPHEN
1245323260 HOOVER B EVE
1982816625 JODI BETH BUSKOHL SOUTHERN IL CHIROPRACTIC CLINIC
1164840740 BOHNERT K MALORIE