Active NPI
Joseph R Baunoch Sr., PSY.D.
- Mental Health Counselor
- Yale, MI
National Provider Identifier
1346442258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39000055A
- Practice address
- 2 S Main St
Yale, MI 48097-3316 - Phone
- (810) 841-4745
- NPI assigned
- Jun 3, 2007
- Last updated
- Sep 7, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | 39000055A | IN | Primary |
| Pastoral Counselor | 101YP1600X | |||
| Professional Counselor | 101YP2500X | 39000055A | IN |
Addresses
Primary practice location
2 S Main St
Yale, MI 48097-3316
Mailing address
2894 W Rick Dr
Port Huron, MI 48060-6533
Phone (810) 841-4745
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39000055A | IN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599436800000",
"number": "1346442258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2894 W RICK DR",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480606533",
"telephone_number": "810-841-4745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 S MAIN ST",
"city": "YALE",
"state": "MI",
"postal_code": "480973316",
"telephone_number": "810-841-4745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUNOCH",
"first_name": "JOSEPH",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-03",
"last_updated": "2020-09-07",
"certification_date": "2020-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000055A",
"primary": true
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IN",
"license": "39000055A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yale, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.