Provider Demographics
NPI:1356464010
Name:BAUM, A. GERI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:A. GERI
Middle Name:
Last Name:BAUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2021
Mailing Address - Country:US
Mailing Address - Phone:516-678-9649
Mailing Address - Fax:516-678-9649
Practice Address - Street 1:100 N VILLAGE AVE
Practice Address - Street 2:SUITE 27
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3767
Practice Address - Country:US
Practice Address - Phone:516-678-9649
Practice Address - Fax:516-678-9649
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58285061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical