Provider Demographics
NPI:1588027585
Name:BABA, KATIE (MSW)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:BABA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 LEDBETTER AVE
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-2040
Mailing Address - Country:US
Mailing Address - Phone:706-715-3414
Mailing Address - Fax:
Practice Address - Street 1:126 LEDBETTER AVE
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-2040
Practice Address - Country:US
Practice Address - Phone:706-715-3414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical