Provider Demographics
NPI:1346361763
Name:BAUMWART, NEAL L (EDD, LMFT, LPC)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:L
Last Name:BAUMWART
Suffix:
Gender:M
Credentials:EDD, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 NW 48
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8363
Mailing Address - Country:US
Mailing Address - Phone:405-840-2138
Mailing Address - Fax:
Practice Address - Street 1:2525 NORTHWEST EXPRESSWAY
Practice Address - Street 2:SUITE 420
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-570-8165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC 1088101YP2500X
OKLMFT 0145106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist