Provider Demographics
NPI:1720249261
Name:BAUGHN, NATHAN SAMUEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:SAMUEL
Last Name:BAUGHN
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 1:3737 GOVERNMENT BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-4310
Mailing Address - Country:US
Mailing Address - Phone:251-300-7134
Mailing Address - Fax:
Practice Address - Street 1:3737 GOVERNMENT BLVD STE 203
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-4310
Practice Address - Country:US
Practice Address - Phone:251-300-7134
Practice Address - Fax:251-202-7851
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1245-2110C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker