Individual provider Active NPI

Wendy Gabel Baum, LCSW-R

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1053684126
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-R#070820 Issued in NY
Practice address
1240 Delaware Ave
Apt 412
Buffalo, NY 14209-1455
Phone
(716) 603-3866
NPI assigned
Feb 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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 LCSW-R#070820 NY Primary

Addresses

Primary practice location

1240 Delaware Ave
Apt 412
Buffalo, NY 14209-1455

Mailing address

1240 Delaware Ave
Apt 412
Buffalo, NY 14209-1455
Phone (716) 603-3866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120322000053 NY Practitioner - Clinical Social Worker 0547420952 Practice locations: Buffalo, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-R#070820NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1053684126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 DELAWARE AVE",
            "address_2": "APT 412",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091455",
            "telephone_number": "716-603-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 DELAWARE AVE",
            "address_2": "APT 412",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091455",
            "telephone_number": "716-603-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUM",
        "first_name": "WENDY",
        "middle_name": "GABEL",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-20",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "LCSW-R#070820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.