Provider Demographics
NPI:1114270220
Name:BAUMSTINGER, KELSEY
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:BAUMSTINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E MAIN ST SUITE 201
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-6410
Mailing Address - Country:US
Mailing Address - Phone:530-648-6508
Mailing Address - Fax:530-273-5930
Practice Address - Street 1:900 E MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945
Practice Address - Country:US
Practice Address - Phone:530-648-6508
Practice Address - Fax:530-273-5930
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator