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NPI Code Detail

MEDICARE: GARY T BAUGHMAN LPCC

MEDICARE: GARY T BAUGHMAN LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.0003661OH
2101YM0800XMental Health CounselorE.0003661OH

General Provider Information

NPI Number : 1063572089
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY T BAUGHMAN LPCC
Provider Business Mailing Address
First Line : 17747 CHILLICOTHE RD
Second Line : SUITE 202
City : CHAGRIN FALLS
State : OH
Zip : 44023-4739
Country : US
Telephone Number : 440-543-8880
Fax Number : 440-543-5911
Provider Business Practice Location Address
First Line : 711 BELMONT AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44502-1039
Country : US
Telephone Number : 330-793-2487
Fax Number : 330-793-2487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 04/14/2022

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