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NPI Code Detail

MEDICARE: DR. ULYSSES GRANT BALDWIN JR. DBH, LCSW-A

MEDICARE: DR. ULYSSES GRANT BALDWIN JR. DBH, LCSW-A
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 Worker

General Provider Information

NPI Number : 1720365729
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ULYSSES GRANT BALDWIN JR. DBH, LCSW-A
Provider Business Mailing Address
First Line : 3050 BERKS WAY
Second Line :
City : RALEIGH
State : NC
Zip : 27614-6598
Country : US
Telephone Number : 984-960-7744
Fax Number :
Provider Business Practice Location Address
First Line : 3050 BERKS WAY
Second Line :
City : RALEIGH
State : NC
Zip : 27614-6598
Country : US
Telephone Number : 984-960-7744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2011
Last Update Date : 01/14/2025

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