Provider Demographics
NPI:1659944288
Name:BALDWIN, CARLY PATRICE (MA, LBS)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:PATRICE
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MA, LBS
Other - Prefix:MRS
Other - First Name:CARLY
Other - Middle Name:PATRICE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LBS
Mailing Address - Street 1:410 N PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3010
Mailing Address - Country:US
Mailing Address - Phone:717-560-7917
Mailing Address - Fax:717-560-6452
Practice Address - Street 1:160 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-3378
Practice Address - Country:US
Practice Address - Phone:717-845-2425
Practice Address - Fax:717-845-2682
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005411101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor