Provider Demographics
NPI:1689765653
Name:BACHMAN, DIANNE OAKEY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:OAKEY
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22404-0446
Mailing Address - Country:US
Mailing Address - Phone:540-845-7622
Mailing Address - Fax:540-322-3774
Practice Address - Street 1:11909 MAIN ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7326
Practice Address - Country:US
Practice Address - Phone:540-845-7622
Practice Address - Fax:540-322-3774
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040018311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q389000281OtherMEDICARE PTAN