Provider Demographics
NPI:1588182711
Name:BACHMAN, JONATHAN (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:BACHMAN
Suffix:
Gender:M
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 COLUMBIA AVE E
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5449
Mailing Address - Country:US
Mailing Address - Phone:269-753-1710
Mailing Address - Fax:269-753-1717
Practice Address - Street 1:842 COLUMBIA AVE E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5449
Practice Address - Country:US
Practice Address - Phone:269-753-1710
Practice Address - Fax:269-753-1717
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-03819101YA0400X
101YA0400X
MI6401019345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)