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NPI Code Detail

MEDICARE: JEROME BALDWIN

MEDICARE: JEROME BALDWIN
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
1101YM0800XMental Health CounselorNY
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1528784675
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEROME BALDWIN
Provider Business Mailing Address
First Line : PO BOX 746087
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6087
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 1048 BEACH 20TH ST
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-3900
Country : US
Telephone Number : 718-765-6342
Fax Number : 929-374-1132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2022
Last Update Date : 05/26/2026

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