MEDICARE: DR. WILLIAM ALLEN BAUGHMAN PH.D.

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	103TA0400X	Addiction (Substance Use Disorder) Psychologist	001355	GA
2	103TB0200X	Cognitive & Behavioral Psychologist	001355	GA
3	103TC0700X	Clinical Psychologist	001355	GA
4	103TC1900X	Counseling Psychologist	001355	GA
5	103TC2200X	Clinical Child & Adolescent Psychologist	001355	GA
6	103T00000X	Psychologist	001355	GA
7	103TP2701X	Group Psychotherapy Psychologist	001355	GA

General Provider Information

NPI Number	:	1780701458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ALLEN BAUGHMAN PH.D.

Provider Business Mailing Address
First Line	:	3364 BRIDLE RUN TRL NW
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-1788
Country	:	US
Telephone Number	:	770-426-4388
Fax Number	:

Provider Business Practice Location Address
First Line	:	3383 POWDER SPRINGS RD
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-2321
Country	:	US
Telephone Number	:	770-222-1980
Fax Number	:	770-222-1981

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	09/11/2025

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