Provider Demographics
NPI:1356676852
Name:BAUGHMAN, JAMES R (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:BAUGHMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 LYNNHAVEN PKWY STE 305
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7350
Mailing Address - Country:US
Mailing Address - Phone:804-280-0826
Mailing Address - Fax:
Practice Address - Street 1:575 LYNNHAVEN PKWY STE 305
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7350
Practice Address - Country:US
Practice Address - Phone:804-280-0826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK88061041C0700X
VA09040102541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200358320AMedicaid