Provider Demographics
NPI:1881431146
Name:BACHANT, DANIELLE CATHERINE (LCSW, MT-BC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CATHERINE
Last Name:BACHANT
Suffix:
Gender:F
Credentials:LCSW, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 HAWTHORNE PL APT 2S
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3253
Mailing Address - Country:US
Mailing Address - Phone:201-563-9854
Mailing Address - Fax:
Practice Address - Street 1:36 HAWTHORNE PL APT 2S
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3253
Practice Address - Country:US
Practice Address - Phone:201-563-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC063500001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty