Provider Demographics
NPI:1811246507
Name:BAUME PSYCHOLOGICAL SERVICES, P.C.
Entity type:Organization
Organization Name:BAUME PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, BAUME PSYCHOLOGICAL SERV
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BAUME
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, HSPP
Authorized Official - Phone:317-706-6744
Mailing Address - Street 1:12337 HANCOCK ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5803
Mailing Address - Country:US
Mailing Address - Phone:317-706-6744
Mailing Address - Fax:317-706-6700
Practice Address - Street 1:12337 HANCOCK ST
Practice Address - Street 2:SUITE 20
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5803
Practice Address - Country:US
Practice Address - Phone:317-706-6744
Practice Address - Fax:317-706-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042084A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201178980AMedicaid
ININ1231Medicare PIN