Provider Demographics
NPI:1326107194
Name:BAUGHMAN, KATHRYN A (LSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:CORDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:4126 TECHNOLOGY WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-2009
Mailing Address - Country:US
Mailing Address - Phone:775-687-7544
Mailing Address - Fax:775-687-7544
Practice Address - Street 1:1665 OLD HOT SPRINGS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0646
Practice Address - Country:US
Practice Address - Phone:775-687-4195
Practice Address - Fax:775-687-5103
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4581-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker