Individual
MR. CHAD ARIK BACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1138 EDGEWOOD AVE S, JACKSONVILLE, FL 32205-5369
(904) 385-0133
Mailing address
1138 EDGEWOOD AVE S, JACKSONVILLE, FL 32205-5369
(904) 385-0133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH13440
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111206300
—
FL
Enumeration date
03/26/2012
Last updated
04/11/2024
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