Provider Demographics
NPI:1427358357
Name:BALDWIN, AMBER M (MSSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:M
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:M
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1112 BATTENBURG TRL
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3038
Mailing Address - Country:US
Mailing Address - Phone:512-589-7565
Mailing Address - Fax:888-864-2717
Practice Address - Street 1:401 E 53RD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-2000
Practice Address - Country:US
Practice Address - Phone:512-589-7565
Practice Address - Fax:888-864-2717
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2013-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX511711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB119195Medicare UPIN