Active NPI
Derek Bacharach, MA
- Professional Counselor
- Montclair, NJ
National Provider Identifier
1942713359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00750900
- Practice address
- 94 Valley Rd
Montclair, NJ 07042-2211 - Phone
- (973) 902-7093
- NPI assigned
- Nov 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00750900 | NJ | Primary |
Addresses
Primary practice location
94 Valley Rd
Montclair, NJ 07042-2211
Mailing address
94 Valley Rd
Montclair, NJ 07042-2211
Phone (973) 902-7093
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00750900 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626739200000",
"number": "1942713359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 VALLEY RD",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422211",
"telephone_number": "973-902-7093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 VALLEY RD",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422211",
"telephone_number": "973-902-7093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACHARACH",
"first_name": "DEREK",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-07",
"last_updated": "2021-07-20",
"certification_date": "2021-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00750900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.