MEDICARE: MR. CHAD ARIK BACKER LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH13440	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376819185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD ARIK BACKER LMHC

Provider Business Mailing Address
First Line	:	1138 EDGEWOOD AVE S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-5369
Country	:	US
Telephone Number	:	904-385-0133
Fax Number	:

Provider Business Practice Location Address
First Line	:	1138 EDGEWOOD AVE S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-5369
Country	:	US
Telephone Number	:	904-385-0133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2012
Last Update Date	:	04/11/2024

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Directions to “ MR. CHAD ARIK BACKER LMHC” Practice Location

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