Provider Demographics
NPI:1578129409
Name:BAUGH, JIMITA RAE (NCC, LMHC)
Entity Type:Individual
Prefix:
First Name:JIMITA
Middle Name:RAE
Last Name:BAUGH
Suffix:
Gender:F
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 SOUNDVIEW DR APT 5E
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-2019
Mailing Address - Country:US
Mailing Address - Phone:360-244-2169
Mailing Address - Fax:
Practice Address - Street 1:6100 SOUNDVIEW DR APT 5E
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2019
Practice Address - Country:US
Practice Address - Phone:360-244-2169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14647101YP2500X
WA61128512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
61346OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS
WALH61128512OtherLICENSED MENTAL HEALTH COUNSELOR
NC14746OtherLICENSED PROFESSIONAL COUNSELOR