Provider Demographics
NPI:1336158435
Name:ZINOMAN-BALDWIN LCSW-R, MICHELE A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:A
Last Name:ZINOMAN-BALDWIN LCSW-R
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 1:409 NEW KARNER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3883
Mailing Address - Country:US
Mailing Address - Phone:518-522-4458
Mailing Address - Fax:518-456-3689
Practice Address - Street 1:409 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3883
Practice Address - Country:US
Practice Address - Phone:518-522-4458
Practice Address - Fax:518-456-3689
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046866-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR88954Medicare UPIN