Provider Demographics
NPI:1205162138
Name:BALDWIN, SHARI (LCSW)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
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:PO BOX 10241
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46411-0241
Mailing Address - Country:US
Mailing Address - Phone:219-940-3045
Mailing Address - Fax:219-940-3045
Practice Address - Street 1:6111 HARRISON ST
Practice Address - Street 2:SUITE 380
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2969
Practice Address - Country:US
Practice Address - Phone:219-940-3045
Practice Address - Fax:219-940-3045
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005925A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000710177OtherANTHEM
IN000000710177OtherANTHEM