Healthcare Provider Details

I. General information

NPI: 1003849142
Provider Name (Legal Business Name): WILLAR M BAUM LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 GREENBRIER CIR STE 100
CHESAPEAKE VA
23320-2645
US

IV. Provider business mailing address

816 GREENBRIER CIR STE 100
CHESAPEAKE VA
23320-2645
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax: 757-301-8803
Mailing address:
  • Phone: 804-207-6737
  • Fax: 757-301-8803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0710102234
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904005016
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: