Provider Demographics
NPI:1518465046
Name:BAUM, JESSICA (LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BAUM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 WORTH AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-6050
Mailing Address - Country:US
Mailing Address - Phone:561-284-9182
Mailing Address - Fax:
Practice Address - Street 1:101 BRADLEY PL STE 206
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-3828
Practice Address - Country:US
Practice Address - Phone:561-284-9182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health