MEDICARE: BALDWIN COUNSELING PLLC

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	0904003880	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891104949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALDWIN COUNSELING PLLC

Provider Business Mailing Address
First Line	:	1492 S INDEPENDENCE BLVD STE 104
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5252
Country	:	US
Telephone Number	:	757-340-0275
Fax Number	:	757-340-0276

Provider Business Practice Location Address
First Line	:	1492 S INDEPENDENCE BLVD STE 104
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5252
Country	:	US
Telephone Number	:	757-340-0275
Fax Number	:	757-340-0276

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SUZANNE MEREDITH BALDWIN
Credential	:	LCSW PH.D.
Telephone Number	:	757-340-0275

Provider Enumeration Date	:	08/02/2014
Last Update Date	:	06/21/2021

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