Keith Schade Baronsky, LCSW
Individual provider Active NPI Clinical Social Worker · Travis Afb, CA
NPI 1679689178 · NPPES record last updated Dec 4, 2015
Key facts
- NPI
- 1679689178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C000673 (NC)
- Practice address
- 60 MDG/Sgow
101 Bodin Cir
Travis Afb, CA 94535-1800 - Phone
- (707) 423-5168
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayne Psychiatric Associates, PA | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C000673 | NC | Yes |
Addresses
Primary practice location
60 MDG/Sgow
101 Bodin Cir
Travis Afb, CA 94535-1800
Mailing address
60 MDG/Sgow
101 Bodin Cir
Travis Afb, CA 94535-1800
Phone (707) 423-5168
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13261 | Other | BCBS | |
| 6002060 | Medicaid | NC |
Other names
- Keith Stephenson
Other providers in Travis Afb, CA
- Jessica Barlow
- Jeremy James Barnett
- Kaitlin May Barnette
- Ryan Barney
- John Peter Baron
- Shannon Barrett
- Jade K Barrow
- Keith John Barton
- Joann L. Basaran
- Corey Baxter
All providers in Travis Afb, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.