MEDICARE: TAMI RA BAHR LCSW, CSAC, ICS

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	7135-123	WI
2	101Y00000X	Counselor	15259-135	WI
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	15135-132	WI
4	104100000X	Social Worker	7135-123	WI
5	1041C0700X	Clinical Social Worker	7135-123	WI

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	:	1568594372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMI RA BAHR LCSW, CSAC, ICS

Provider Business Mailing Address
First Line	:	6410 ENTERPRISE LN STE 210
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53719-1143
Country	:	US
Telephone Number	:	608-400-3672
Fax Number	:	608-422-4006

Provider Business Practice Location Address
First Line	:	6410 ENTERPRISE LN STE 210
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53719-1143
Country	:	US
Telephone Number	:	608-400-3672
Fax Number	:	608-422-4006

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

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	03/07/2024

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