Provider Demographics
NPI:1134107501
Name:BAUBE, ERIKA ANN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:ANN
Last Name:BAUBE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1872 MONTREAL RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5709
Mailing Address - Country:US
Mailing Address - Phone:770-496-9400
Mailing Address - Fax:770-496-9495
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:SUITE 701
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:404-294-8750
Practice Address - Fax:404-294-9664
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW00030241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP62634Medicare UPIN
GA80BBFMMMedicare ID - Type Unspecified