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General NPI Number Information
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NPI Number | 1033405949
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Entity Type | Individual
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Provider Name | ROGER BACHRACH LMHC , LMSW
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Gender | Male
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PENTHOUSE
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 917-902-9203
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Fax | 212-239-0948
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Provider Business Mailing Address
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Address Line | 301 E 79TH ST APT 24F
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City | NEW YORK
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State | NY
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Zip | 10075-0945
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Country | US
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Telephone | 212-535-4717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 039729-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000795-1
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License Number State | NY
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