Provider Demographics
NPI:1407986839
Name:BAUGHMAN, ANN MARIE (LISW)
Entity Type:Individual
Prefix:MS
First Name:ANN MARIE
Middle Name:
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 OFFICE PARK ROAD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2505
Mailing Address - Country:US
Mailing Address - Phone:515-255-3313
Mailing Address - Fax:515-223-6184
Practice Address - Street 1:939 OFFICE PARK ROAD
Practice Address - Street 2:SUITE 316
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2505
Practice Address - Country:US
Practice Address - Phone:515-255-3313
Practice Address - Fax:515-223-6184
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0400135Medicaid
IA049924Medicare ID - Type Unspecified