Provider Demographics
NPI:1407014293
Name:JOHN T. BAUGHMAN PHD LPC PLLC
Entity Type:Organization
Organization Name:JOHN T. BAUGHMAN PHD LPC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BAUGHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPC
Authorized Official - Phone:254-366-0114
Mailing Address - Street 1:1000 W STATE HIGHWAY 6
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3786
Mailing Address - Country:US
Mailing Address - Phone:254-366-0114
Mailing Address - Fax:254-296-0796
Practice Address - Street 1:1000 W STATE HIGHWAY 6
Practice Address - Street 2:SUITE 150
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3786
Practice Address - Country:US
Practice Address - Phone:254-366-0114
Practice Address - Fax:254-296-0796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00200XMedicare UPIN