Provider Demographics
NPI:1417517798
Name:JAMES D BAUGH
Entity Type:Organization
Organization Name:JAMES D BAUGH
Other - Org Name:CUTTING EDGE ENTERPRISES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TIN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-322-4515
Mailing Address - Street 1:9191 S ROCKPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47462-8400
Mailing Address - Country:US
Mailing Address - Phone:812-322-4515
Mailing Address - Fax:
Practice Address - Street 1:4101 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-5539
Practice Address - Country:US
Practice Address - Phone:812-322-4515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty