Michael J. Bachop, PH.D.
Individual provider Active NPI Clinical Psychologist · Arcadia, FL
NPI 1003149576 · NPPES record last updated May 27, 2021
Key facts
- NPI
- 1003149576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY11082 (FL)
- Practice address
- 725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752 - Phone
- (941) 776-4000
- NPI assigned
- Sep 15, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210604001887 | FL | Practitioner - Clinical Psychologist | 5092953059 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY11082 | FL | MD | Clinical Psychologist |
| 2009026784 | MO | MD | Group Psychotherapy Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCR Health, Inc. | Current |
Accepting new patients | |
| MCR Health, Inc. | Current |
Accepting new patients |
Locations
725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242
725 N 12th Ave
#B
Arcadia, FL 34266
Phone (863) 494-1242
700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008
12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 2009026784 | MO | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 2009026784 | MO | |
| Clinical Psychologist | 103TC0700X | 2009026784 | MO | |
| Group Psychotherapy Psychologist | 103TP2701X | 2009026784 | MO | |
| Clinical Psychologist | 103TC0700X | PY11082 | FL | Yes |
Addresses
Primary practice location
725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752
Mailing address
700 8TH Ave W Ste 101
Palmetto, FL 34221-4737
Phone (941) 776-4000
Other providers in Arcadia, FL
- Arcadia Pediatrics PLC
- Elizabeth Arevalo
- Jessica S Arnett
- Sandra I Arocho Rodriguez
- Gregory Arov
- Hannah Grace Bair
- Nancy A Ballard
- Raena Roshana Baptiste-Boles
- Ileana Bascuas
- Celia Pearl Bateman
All providers in Arcadia, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.