Provider Demographics
NPI:1740954833
Name:BACHRODT, APRIL M (LCSW, PHD)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:M
Last Name:BACHRODT
Suffix:
Gender:F
Credentials:LCSW, PHD
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 3394
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-3394
Mailing Address - Country:US
Mailing Address - Phone:479-313-1502
Mailing Address - Fax:
Practice Address - Street 1:624 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-1909
Practice Address - Country:US
Practice Address - Phone:479-301-2326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8340-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR8340-COtherSOCIAL WORK LICENSE