Individual provider Active NPI

Elizabeth Laird Baumann, LCSW

  • Clinical Social Worker
  • Berrien Springs, MI
National Provider Identifier
1063248078
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114109 Issued in MI
Practice address
11022 Red Bud TRL
Berrien Springs, MI 49103-9625
Phone
(574) 261-4532
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34009891A IN
Clinical Social Worker 1041C0700X 6801114109 MI Primary

Addresses

Primary practice location

11022 Red Bud TRL
Berrien Springs, MI 49103-9625

Mailing address

11022 Red Bud TRL
Berrien Springs, MI 49103-9625
Phone (574) 261-4532

Other names 1

  • Elizabeth Laird Coulston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34009891AINMDClinical Social Worker
6801114109MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1063248078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11022 RED BUD TRL",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039625",
            "telephone_number": "574-261-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11022 RED BUD TRL",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039625",
            "telephone_number": "574-261-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMANN",
        "first_name": "ELIZABETH",
        "middle_name": "LAIRD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009891A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "COULSTON",
            "middle_name": "LAIRD",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berrien Springs, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.