Healthcare Provider Details

I. General information

NPI: 1629931373
Provider Name (Legal Business Name): ROBERT W. BAER, PSYD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 21ST ST W STE A
DICKINSON ND
58601-2647
US

IV. Provider business mailing address

1120 14TH ST W APT 2
DICKINSON ND
58601-2838
US

V. Phone/Fax

Practice location:
  • Phone: 701-590-0239
  • Fax:
Mailing address:
  • Phone: 701-590-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT WARREN BAER
Title or Position: OWNER
Credential: PSYD
Phone: 701-590-0238