Victoria Baum, LCPC, NCC

Individual provider Active NPI Professional Counselor · Evanston, IL

NPI 1194919043 · NPPES record last updated Sep 4, 2007

Key facts

NPI
1194919043
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
2530 Crawford Ave
Suite 114
Evanston, IL 60201-4970
Phone
(847) 373-0456
Fax
(847) 866-0456
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
180-006479ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL Yes

Addresses

Primary practice location

2530 Crawford Ave
Suite 114
Evanston, IL 60201-4970

Mailing address

2530 Crawford Ave
Suite 114
Evanston, IL 60201-4970
Phone (847) 373-0456

Other providers in Evanston, IL

All providers in Evanston, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.