Provider Demographics
NPI:1922333293
Name:BAUMGART, EMILY LAUREN (LICSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LAUREN
Last Name:BAUMGART
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-2839
Mailing Address - Country:US
Mailing Address - Phone:508-993-1483
Mailing Address - Fax:
Practice Address - Street 1:24 MAIN ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4620
Practice Address - Country:US
Practice Address - Phone:508-679-0183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical