Provider Demographics
NPI:1891104949
Name:BALDWIN COUNSELING PLLC
Entity Type:Organization
Organization Name:BALDWIN COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MEREDITH
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW PHD
Authorized Official - Phone:757-340-0275
Mailing Address - Street 1:1492 S INDEPENDENCE BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5252
Mailing Address - Country:US
Mailing Address - Phone:757-340-0275
Mailing Address - Fax:757-340-0276
Practice Address - Street 1:1492 S INDEPENDENCE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5252
Practice Address - Country:US
Practice Address - Phone:757-340-0275
Practice Address - Fax:757-340-0276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-02
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040038801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1154871Medicaid
VA1154871Medicaid