Individual provider Active NPI

Jacquelyn Emma Bahling, MA, LPC, NCC

  • Mental Health Counselor
  • Scottsdale, AZ
National Provider Identifier
1427555200
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC21007 Issued in AZ
Practice address
8705 E McDowell Rd
Scottsdale, AZ 85257-3909
Phone
(480) 882-4545
Fax
(480) 405-8929
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401018894 MI
Mental Health Counselor 101YM0800X LPC21007 AZ Primary

Addresses

Primary practice location

8705 E McDowell Rd
Scottsdale, AZ 85257-3909

Mailing address

7500 N Dreamy Draw Dr Ste 145
Phoenix, AZ 85020-4668
Phone (480) 882-4545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614003036 AZ Practitioner - Mental Health Counselor 1759824097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11851 N 51St Ave
Suite F140
Glendale, AZ 85304-2847
Phone (480) 882-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC21007AZMDMental Health Counselor
6401018894MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Outreach Access to Health Mental Health CurrentSince Jun 3, 2024 Accepting new patients
Neighborhood Outreach Access to Health CurrentSince Jun 3, 2024 Accepting new patients
County of Washtenaw PastSince Sep 1, 2021 Accepting new patients
County of Washtenaw PastSince Sep 1, 2021 Accepting new patients

Locations

11851 N 51st Ave
Ste B110
Glendale, AZ 85304

11851 N 51st Ave
Ste F140
Glendale, AZ 85304
Phone (623) 428-0001

9015 N 3rd St
Phoenix, AZ 85020

7500 N Dreamy Draw Dr
Ste 145
Phoenix, AZ 85020

20440 N 27th Ave
Phoenix, AZ 85027

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

16251 N Cave Creek Rd
Phoenix, AZ 85032

8705 E McDowell Rd
Scottsdale, AZ 85257

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1427555200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 E MCDOWELL RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573909",
            "telephone_number": "480-882-4545",
            "fax_number": "480-405-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHLING",
        "first_name": "JACQUELYN",
        "middle_name": "EMMA",
        "name_prefix": "Ms.",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401018894",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC21007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.