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NPI Code Detail

MEDICARE: SUSANNE C. BAUGHMAN LCSW

MEDICARE: SUSANNE C. BAUGHMAN 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
11041C0700XClinical Social Worker34004346AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000491067OTHERINANTHEM BCBS PROVIDER PIN
2000000889796OTHERINANTHEM

General Provider Information

NPI Number : 1568566586
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANNE C. BAUGHMAN LCSW
Provider Business Mailing Address
First Line : 6626 E 75TH STREET
Second Line : STE 500
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2040 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-1734
Country : US
Telephone Number : 317-355-1800
Fax Number : 317-355-1803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 11/04/2020

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Directions to “ SUSANNE C. BAUGHMAN LCSW” Practice Location

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