Provider Demographics
NPI:1356676852
Name:BAUGHMAN, JAMES R (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:BAUGHMAN
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 1:64OO S. LEWIS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-0000
Mailing Address - Country:US
Mailing Address - Phone:918-270-4100
Mailing Address - Fax:
Practice Address - Street 1:64OO S. LEWIS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-0000
Practice Address - Country:US
Practice Address - Phone:918-270-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040102541041C0700X
OK88061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200358320AMedicaid