Provider Demographics
NPI:1255722245
Name:BACHBAUER, KUNO RUDOLPH (LMFT)
Entity type:Individual
Prefix:DR
First Name:KUNO
Middle Name:RUDOLPH
Last Name:BACHBAUER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 NELSON ST
Mailing Address - Street 2:SUITE #204
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2031
Mailing Address - Country:US
Mailing Address - Phone:301-762-5866
Mailing Address - Fax:
Practice Address - Street 1:2604 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE #200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1547
Practice Address - Country:US
Practice Address - Phone:240-899-1833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLMFT000102106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist