MEDICARE: ASHLEY BAUM LCSW

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
1	1041C0700X	Clinical Social Worker	97917	CA

General Provider Information

NPI Number	:	1124620513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY BAUM LCSW

Provider Business Mailing Address
First Line	:	7257 BEVERLY BLVD STE 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2567
Country	:	US
Telephone Number	:	323-456-3813
Fax Number	:

Provider Business Practice Location Address
First Line	:	7257 BEVERLY BLVD STE 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2567
Country	:	US
Telephone Number	:	323-456-3813
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2020
Last Update Date	:	03/28/2022

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