Healthcare Provider Details

I. General information

NPI: 1750976999
Provider Name (Legal Business Name): BALDWIN THERAPY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 15TH ST SW # LL5
MINOT ND
58701-6935
US

IV. Provider business mailing address

2201 15TH ST SW # LL5
MINOT ND
58701-6935
US

V. Phone/Fax

Practice location:
  • Phone: 701-838-9550
  • Fax: 701-838-9569
Mailing address:
  • Phone: 701-340-1216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. TRICIA BALDWIN
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: LICSW
Phone: 701-340-1216