Provider Demographics
NPI:1851792709
Name:BAUGH, CRYSTAL MARIE (MH 13505)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MARIE
Last Name:BAUGH
Suffix:
Gender:F
Credentials:MH 13505
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MEDICAL CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5423
Mailing Address - Country:US
Mailing Address - Phone:863-382-9280
Mailing Address - Fax:863-382-6299
Practice Address - Street 1:6412 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33876-5711
Practice Address - Country:US
Practice Address - Phone:863-991-3232
Practice Address - Fax:866-634-3605
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13505101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health