Provider Demographics
NPI:1841761137
Name:BASKIN, COREY (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:BASKIN
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 GOLD ST
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-4220
Mailing Address - Country:US
Mailing Address - Phone:225-588-8765
Mailing Address - Fax:
Practice Address - Street 1:6009 FINANCIAL PLZ STE 10571129
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2615
Practice Address - Country:US
Practice Address - Phone:318-670-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16754104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker