Provider Demographics
NPI:1659630119
Name:BALDRIDGE, MEGHAN ELIZABETH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:BALDRIDGE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 JUNIOR CT
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-2531
Mailing Address - Country:US
Mailing Address - Phone:618-570-2271
Mailing Address - Fax:
Practice Address - Street 1:111 AVENUE O W
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5634
Practice Address - Country:US
Practice Address - Phone:515-573-2193
Practice Address - Fax:515-573-2798
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0078751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical