MEDICARE: DR. ALVIA LESHEA BALDWIN PH.D, LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	61204	TX

General Provider Information

NPI Number	:	1124265434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALVIA LESHEA BALDWIN PH.D, LPC, NCC

Provider Business Mailing Address
First Line	:	2910 ASHFORD PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2208
Country	:	US
Telephone Number	:	281-352-5534
Fax Number	:	281-531-8344

Provider Business Practice Location Address
First Line	:	2910 ASHFORD PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2208
Country	:	US
Telephone Number	:	281-352-5534
Fax Number	:	281-531-8344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	01/09/2009

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