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General NPI Number Information
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NPI Number | 1760667042
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Entity Type | Individual
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Provider Name | LEWIS MICHAEL BALDWIN III MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 2957 HC TURNER RD
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City | PINK HILL
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State | NC
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Zip | 28572-9522
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Country | US
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Telephone | 910-232-9885
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Fax |
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Provider Business Mailing Address
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Address Line | 2957 HC TURNER RD
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City | PINK HILL
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State | NC
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Zip | 28572-9522
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Country | US
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Telephone | 910-232-9885
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C006151
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License Number State | NC
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