Carmen Baldus, ED.D.
Individual provider Active NPI Psychologist · Newaygo, MI
NPI 1447403241 · NPPES record last updated Apr 18, 2019
Key facts
- NPI
- 1447403241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 6301011963 (MI)
- Practice address
- 7769 S River Ridge Rd
Newaygo, MI 49337-9673 - Phone
- (231) 652-7200
- Fax
- (231) 652-7201
- NPI assigned
- Oct 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301011963 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Creation Psychological Servies | Psychologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301011963 | MI | Yes |
Addresses
Primary practice location
7769 S River Ridge Rd
Newaygo, MI 49337-9673
Mailing address
7760 S River Ridge Rd
Newaygo, MI 49337-9673
Phone (231) 373-7969
Other providers in Newaygo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.