Provider Demographics
NPI:1548970072
Name:AMBER BACH GORMAN COUNSELING & CONSULTING - PLLC
Entity type:Organization
Organization Name:AMBER BACH GORMAN COUNSELING & CONSULTING - PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:BACH-GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-419-8702
Mailing Address - Street 1:3227 OAK RIDGE LOOP E STE 205
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8482
Mailing Address - Country:US
Mailing Address - Phone:701-419-8702
Mailing Address - Fax:701-520-8457
Practice Address - Street 1:3227 OAK RIDGE LOOP E STE 205
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8482
Practice Address - Country:US
Practice Address - Phone:701-419-8702
Practice Address - Fax:701-520-8457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty