Provider Demographics
NPI:1982854477
Name:BALDWIN, RHONDA LEE (PCC)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LEE
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6310
Mailing Address - Country:US
Mailing Address - Phone:740-387-5210
Mailing Address - Fax:
Practice Address - Street 1:500 GROTTO ST N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-1754
Practice Address - Country:US
Practice Address - Phone:651-760-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH981006101YA0400X
OHE0003660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)