MEDICARE: BACH COUNSELING SERVICES, LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1538696992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACH COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	1575 N LACROSSE ST STE H
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-6969
Country	:	US
Telephone Number	:	605-431-4106
Fax Number	:

Provider Business Practice Location Address
First Line	:	1575 N LACROSSE ST STE H
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-6969
Country	:	US
Telephone Number	:	605-431-4106
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MENTAL HEALTH COUNSELOR
Name	:	MS. S MAHALA BACH
Credential	:	LPC-MH, QMHP
Telephone Number	:	605-431-4106

Provider Enumeration Date	:	05/16/2017
Last Update Date	:	07/21/2022

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