Provider Demographics
NPI:1407298318
Name:BAPTIST, NANCY (LMHC NCC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:BAPTIST
Suffix:
Gender:F
Credentials:LMHC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6459 EGRET LN
Mailing Address - Street 2:#420
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-4214
Mailing Address - Country:US
Mailing Address - Phone:941-556-1377
Mailing Address - Fax:
Practice Address - Street 1:4916 26TH ST W
Practice Address - Street 2:#100
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-1712
Practice Address - Country:US
Practice Address - Phone:941-556-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9354101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health