Provider Demographics
NPI:1780466029
Name:BAUGHMAN SHELTON, AMANDA DAWN (MSW)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:DAWN
Last Name:BAUGHMAN SHELTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:DAWN
Other - Last Name:BAUGHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:415 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651
Mailing Address - Country:US
Mailing Address - Phone:304-872-1663
Mailing Address - Fax:
Practice Address - Street 1:415 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-1343
Practice Address - Country:US
Practice Address - Phone:304-872-1663
Practice Address - Fax:304-872-1804
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker