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General NPI Number Information
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NPI Number | 1437467479
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Entity Type | Organization
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Legal Business Name | ELLEN R BACHMEYER LCSW LLC
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 07/09/2015
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Provider Practice Location Address
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Address Line | 270 CAMPBELL AVE
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City | THE VILLAGES
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State | FL
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Zip | 32162-5389
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Country | US
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Telephone | 352-209-6211
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Fax | 407-217-6632
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Provider Business Mailing Address
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Address Line | PO BOX 770575
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City | WINTER GARDEN
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State | FL
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Zip | 34777-0575
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Country | US
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Telephone | 352-209-6211
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Fax | 407-217-6632
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Authorized Official
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Title or Position | OWNER
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Name | ELLEN R BACHMEYER
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Credential | LCSW
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Telephone | 352-209-6211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW3292
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License Number State | FL
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