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NPI Code Detail

MEDICARE: NINA A WALLES-BALDWIN MSW, LCSW

MEDICARE: NINA A WALLES-BALDWIN MSW, LCSW
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
11041C0700XClinical Social Worker2026002815MO

General Provider Information

NPI Number : 1316711567
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINA A WALLES-BALDWIN MSW, LCSW
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 417-761-5214
Fax Number :
Provider Business Practice Location Address
First Line : 800 S PARK AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65802-4855
Country : US
Telephone Number : 417-893-7735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2023
Last Update Date : 02/09/2026

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