Healthcare Provider Details

I. General information

NPI: 1720151947
Provider Name (Legal Business Name): JAMES R. BAIZE JR. D.MIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909B S KENMORE DR
EVANSVILLE IN
47714-7514
US

IV. Provider business mailing address

7700 HAHNS LN
EVANSVILLE IN
47712-8514
US

V. Phone/Fax

Practice location:
  • Phone: 812-402-9292
  • Fax: 812-402-8090
Mailing address:
  • Phone: 812-985-2716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34002310A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35000009A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: