MEDICARE: TALIA BALDINI LCSW, CADC

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	1041C0700X	Clinical Social Worker	Q1-0012311	DE
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	2037	DE
3	1041C0700X	Clinical Social Worker	CW024141	PA

General Provider Information

NPI Number	:	1487406294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TALIA BALDINI LCSW, CADC

Provider Business Mailing Address
First Line	:	2207 CONCORD PIKE # 291
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19803-2908
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2207 CONCORD PIKE # 291
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19803-2908
Country	:	US
Telephone Number	:	302-898-6001
Fax Number	:

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

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	04/04/2024

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