J M Baldus, Inc
Organization Active NPI Adult Mental Health Clinic/Center · Mound, MN
NPI 1730520172 · NPPES record last updated Jul 15, 2013
Key facts
- NPI
- 1730520172
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Mental Health Clinic/Center 261QM0850X
- License
- LP0796 (MN)
- Legal business name
- J M BALDUS, INC
- Practice address
- 5200 Maywood Rd
Mound, MN 55364-1775 - Phone
- (763) 913-6292
- NPI assigned
- Jul 15, 2013
- Organization subpart
- No
Authorized official
- Name
- James Michael Baldus, PHD, LP
- Title
- Psychologist
- Phone
- (763) 913-6292
Practitioners 2
-
James Michael Baldus, PH.D., L.P.
-
Daniel Paul Doshan, M.A., L.P.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | LP0796 | MN | Yes |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | LP0796 | MN |
Addresses
Primary practice location
5200 Maywood Rd
Mound, MN 55364-1775
Mailing address
3032 Highview LN
Mound, MN 55364-9422
Phone (763) 913-6292
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6500552000 | Medicaid | MN |
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All providers in Mound, MN · Adult Mental Health Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2013. 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.