MEDICARE: AMBER NICOL BAUGNET MA, LPC

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	101YP2500X	Professional Counselor	5250-125	WI

General Provider Information

NPI Number	:	1497893283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER NICOL BAUGNET MA, LPC

Provider Business Mailing Address
First Line	:	1263 MAIN ST STE 122
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54302-1341
Country	:	US
Telephone Number	:	920-415-2002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1263 MAIN ST STE 122
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54302-1341
Country	:	US
Telephone Number	:	920-415-2002
Fax Number	:

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	12/17/2025

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