MEDICARE: DR. BAOCHUN HIND

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	101Y00000X	Counselor	180.012440	IL
2	101YP2500X	Professional Counselor	6401013180	MI
3	101YM0800X	Mental Health Counselor	39003636A	IN

General Provider Information

NPI Number	:	1770191892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BAOCHUN HIND

Provider Business Mailing Address
First Line	:	1205 E BRONSON ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-1141
Country	:	US
Telephone Number	:	509-338-5834
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 E BRONSON ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-1141
Country	:	US
Telephone Number	:	509-338-5834
Fax Number	:

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

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	07/15/2020

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Directions to “ DR. BAOCHUN HIND ” Practice Location

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