Healthcare Provider Details

I. General information

NPI: 1326957390
Provider Name (Legal Business Name): JENNA MARIE BAUM M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 HOLDREGE ST APT 308
LINCOLN NE
68504-3173
US

IV. Provider business mailing address

5905 O ST
LINCOLN NE
68510-2235
US

V. Phone/Fax

Practice location:
  • Phone: 402-450-0221
  • Fax:
Mailing address:
  • Phone: 402-436-1623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: