NPIMap

Connie Dennise Baldwin, MS, LMHC(FL),LPC(TX)

Individual provider Active NPI Professional Counselor · Crestview, FL

NPI 1487983367 · NPPES record last updated Apr 23, 2018

Key facts

NPI
1487983367
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
MH5223 (FL)
Practice address
3922 Jace Dr
Crestview, FL 32539-6510
Phone
(210) 885-5963
NPI assigned
Dec 23, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH5223FLMDProfessional Counselor
10460723-6004UTMDProfessional Counselor
63853TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hoof Steps Corporation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 63853 TX
Professional Counselor 101YP2500X 10460723-6004 UT
Professional Counselor 101YP2500X MH5223 FL Yes

Addresses

Primary practice location

3922 Jace Dr
Crestview, FL 32539-6510

Mailing address

405 Olde Post Rd
Niceville, FL 32578-3905
Phone (210) 885-5963

Other providers in Crestview, FL

All providers in Crestview, FL · Professional Counselor in Florida

Sources for this page

Verify at the official NPI Registry.