Provider Demographics
NPI:1669281002
Name:BAUM THERAPY LLC
Entity type:Organization
Organization Name:BAUM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LCPC
Authorized Official - Prefix:
Authorized Official - First Name:SHASTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUM-STRAIT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-546-3224
Mailing Address - Street 1:314 1ST ST E STE 204
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-2100
Mailing Address - Country:US
Mailing Address - Phone:406-546-3224
Mailing Address - Fax:
Practice Address - Street 1:314 1ST ST E STE 204
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-2100
Practice Address - Country:US
Practice Address - Phone:406-546-3224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty