Baldwin, Mark

Baldwin, Mark is an sole proprietor health care provider with primary practice located at 575 S Royal St Suite 24, Jackson TN 38301-7307. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Baldwin, Mark can be contacted via phone (731) 467-0504.

Contact Information

Primary practice address
575 S Royal St Suite 24 Jackson TN 38301-7307
Phone: (731) 467-0504
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1878 Tennessee
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 1878 Tennessee

Profile Details

NPI number 1407069321
LBN Legal business name Baldwin, Mark
Credentials LPC-MHSP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 7th, 2007
Last updated Mar 3rd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407069321 NPPES
Tennessee MEDICAID 1506474

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