Provider Demographics
NPI:1487011870
Name:BAUMAN, AUDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:AUDRA
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850082
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70185-0082
Mailing Address - Country:US
Mailing Address - Phone:504-821-7085
Mailing Address - Fax:504-304-2276
Practice Address - Street 1:1050 S JEFFERSON DAVIS PKWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1200
Practice Address - Country:US
Practice Address - Phone:504-821-7085
Practice Address - Fax:504-304-2276
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA109581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical