Provider Demographics
NPI:1982029310
Name:BAUMWOLL, ADAM (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:BAUMWOLL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MOUNTAIN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3152
Mailing Address - Country:US
Mailing Address - Phone:908-233-7801
Mailing Address - Fax:
Practice Address - Street 1:202 MOUNTAIN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3152
Practice Address - Country:US
Practice Address - Phone:908-233-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055698001041C0700X
NY730810591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical