Mary Bahr, SACIT | NPI 1841616596

Key facts

NPI: 1841616596
Entity type: Individual (NPI type 1)
Primary specialty: Addiction (Substance Use Disorder) Counselor 101YA0400X
License: 16972-130 (WI)
Practice address: 201 S Glenridge CT
Appleton, WI 54914-3905
Phone: (920) 731-3981
NPI assigned: Mar 5, 2014
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Mooring Programs, Inc Substance Abuse Rehabilitation Facility · Appleton, WI · NPI 1760709299

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
16972-130	WI	MD	Addiction (Substance Use Disorder) Counselor

Practice roles

Organization	Specialty	Status	New patients
Mooring Programs, Inc		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X	16972-130	WI	Yes

Addresses

Primary practice location

201 S Glenridge CT
Appleton, WI 54914-3905

Mailing address

607 W 7TH St
Appleton, WI 54911-5923
Phone (920) 739-3235

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 5, 2014.

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1841616596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W 7TH ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115923",
            "telephone_number": "920-739-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S GLENRIDGE CT",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143905",
            "telephone_number": "920-731-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHR",
        "first_name": "MARY",
        "credential": "SACIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16972-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

All providers in Appleton, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.