Individual provider Active NPI

Trevor Dean Baines, LCSW

  • Clinical Social Worker
  • Panama City, FL
National Provider Identifier
1003163528
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13426 Issued in FL
Practice address
2711 W 15TH St
Panama City, FL 32401-1366
Phone
(850) 769-6001
Fax
(850) 769-6003
NPI assigned
Aug 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13426 FL Primary

Addresses

Primary practice location

2711 W 15TH St
Panama City, FL 32401-1366

Mailing address

2711 W 15TH St
Panama City, FL 32401-1366
Phone (850) 769-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13426FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Therapy Services, Inc PastSince Jul 17, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1003163528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 W 15TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324011366",
            "telephone_number": "850-769-6001",
            "fax_number": "850-769-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 W 15TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324011366",
            "telephone_number": "850-769-6001",
            "fax_number": "850-769-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINES",
        "first_name": "TREVOR",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-14",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "13426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.