Provider Demographics
NPI:1497893283
Name:BAUGNET, AMBER NICOL (MA, LPC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOL
Last Name:BAUGNET
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9544 DOLATA LN
Mailing Address - Street 2:
Mailing Address - City:KRAKOW
Mailing Address - State:WI
Mailing Address - Zip Code:54137-9733
Mailing Address - Country:US
Mailing Address - Phone:920-604-1819
Mailing Address - Fax:
Practice Address - Street 1:9544 DOLATA LN
Practice Address - Street 2:
Practice Address - City:KRAKOW
Practice Address - State:WI
Practice Address - Zip Code:54137-9733
Practice Address - Country:US
Practice Address - Phone:920-604-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5250-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional