Provider Demographics
NPI:1912270935
Name:BALDWIN, CORINA (LLMSW)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:CORINA
Other - Middle Name:
Other - Last Name:BALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3895 LAKEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-3036
Mailing Address - Country:US
Mailing Address - Phone:248-252-3741
Mailing Address - Fax:248-499-9937
Practice Address - Street 1:22255 GREENFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3729
Practice Address - Country:US
Practice Address - Phone:248-849-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801095271104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker