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NPI Code Detail

MEDICARE: BRITTANNY CAROL BAUM MA, LPC

MEDICARE: BRITTANNY CAROL BAUM MA, LPC
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
1172A00000XDriverEW64364WV
2101YP2500XProfessional Counselor2415WV

General Provider Information

NPI Number : 1346716040
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANNY CAROL BAUM MA, LPC
Provider Business Mailing Address
First Line : 41 NEW THOMAS DR
Second Line :
City : CHARLES TOWN
State : WV
Zip : 25414-4822
Country : US
Telephone Number : 304-270-8682
Fax Number :
Provider Business Practice Location Address
First Line : 1020 WINCHESTER AVE
Second Line :
City : MARTINSBURG
State : WV
Zip : 25401-1650
Country : US
Telephone Number : 304-886-4118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2018
Last Update Date : 05/01/2019

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