Provider Demographics
NPI:1467805903
Name:BAUGHMAN, LIZ MICHELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:LIZ
Middle Name:MICHELLE
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 PEARL ST. SUITE 3
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-666-1553
Mailing Address - Fax:541-919-3533
Practice Address - Street 1:1234 PEARL ST. SUITE 3
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-666-1553
Practice Address - Fax:541-919-3533
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORT1563106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT1563OtherLICENSE NUMBER
OR500712629Medicaid