Provider Demographics
NPI:1447478615
Name:BAUM, BARBARA A (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BAUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4201 TUDOR CENTRE DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5904
Mailing Address - Country:US
Mailing Address - Phone:907-729-8624
Mailing Address - Fax:907-729-8650
Practice Address - Street 1:4341 TUDOR CENTRE DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5904
Practice Address - Country:US
Practice Address - Phone:907-729-8624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK8EM083Medicare PIN
AK8EM088Medicare PIN
AK8EE633Medicare PIN
AK8EM086Medicare PIN
AK8EM084Medicare PIN
AK8EM085Medicare PIN
AK8EM087Medicare PIN
AK8EM082Medicare PIN