Provider Demographics
NPI:1982843694
Name:BAUM, JOANNE (LCSW, PHD CAC III)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:BAUM
Suffix:
Gender:F
Credentials:LCSW, PHD CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30752 SOUTHVIEW DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7990
Mailing Address - Country:US
Mailing Address - Phone:303-670-3948
Mailing Address - Fax:
Practice Address - Street 1:30752 SOUTHVIEW DR
Practice Address - Street 2:SUITE 120
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7990
Practice Address - Country:US
Practice Address - Phone:303-670-3948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLCSW LT8930104100000X
COLCSW #LT89301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker