Provider Demographics
NPI:1437472453
Name:BAUM, LAURIE (LAURIE BAUM, MSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:BAUM
Suffix:
Gender:F
Credentials:LAURIE BAUM, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 B SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CT
Mailing Address - Zip Code:92024
Mailing Address - Country:US
Mailing Address - Phone:760-753-7676
Mailing Address - Fax:760-753-6262
Practice Address - Street 1:901 B SECOND STREET
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CT
Practice Address - Zip Code:92024
Practice Address - Country:US
Practice Address - Phone:760-753-7676
Practice Address - Fax:760-753-6262
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0439051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical