Provider Demographics
NPI:1346652088
Name:BAUMGARDNER, CHRISTINE M (LISW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:BAUMGARDNER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:KEMPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:1918 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:419-425-5050
Mailing Address - Fax:419-423-7854
Practice Address - Street 1:1918 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-425-5050
Practice Address - Fax:419-423-7854
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1201251104100000X
OHI 16002901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0195744Medicaid