Provider Demographics
NPI:1215035522
Name:BACHMANN, TALITHA S (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:TALITHA
Middle Name:S
Last Name:BACHMANN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:BACHMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:6717 S YALE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3328
Mailing Address - Country:US
Mailing Address - Phone:918-369-4950
Mailing Address - Fax:918-369-4951
Practice Address - Street 1:6717 S YALE AVE STE 202
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3328
Practice Address - Country:US
Practice Address - Phone:918-369-4950
Practice Address - Fax:918-369-4951
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3728101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional