Provider Demographics
NPI:1104361567
Name:BAXTER, JANE (PHD, MSW)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:BAXTER
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 P ST NW STE 600
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6920
Mailing Address - Country:US
Mailing Address - Phone:202-744-4381
Mailing Address - Fax:
Practice Address - Street 1:2000 P ST NW STE 600
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6920
Practice Address - Country:US
Practice Address - Phone:202-744-4381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3029531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical