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NPI Code Detail

MEDICARE: BRIAN BACHMAN LPC

MEDICARE:   BRIAN  BACHMAN  LPC
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
1101YP2500XProfessional Counselor2018043310MO
2101YM0800XMental Health Counselor2018043310MO

General Provider Information

NPI Number : 1528657103
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN BACHMAN LPC
Provider Business Mailing Address
First Line : 1055 CAROLE LN
Second Line :
City : ELLISVILLE
State : MO
Zip : 63021-4727
Country : US
Telephone Number : 314-775-3062
Fax Number :
Provider Business Practice Location Address
First Line : 7905 BIG BEND BLVD STE 200
Second Line :
City : WEBSTER GROVES
State : MO
Zip : 63119-2715
Country : US
Telephone Number : 314-775-3062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2021
Last Update Date : 01/18/2021

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Directions to “ BRIAN BACHMAN LPC” Practice Location

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