Active NPI
Mary Baumberger, LCSW
- Clinical Social Worker
- Russellville, AR
National Provider Identifier
1790035533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6576-C
- Practice address
- 1301 West 2ND Court
Russellville, AR 72801 - Phone
- (479) 567-5654
- Fax
- (479) 567-5661
- NPI assigned
- Sep 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6576-C | AR | Primary |
Addresses
Primary practice location
1301 West 2ND Court
Russellville, AR 72801
Mailing address
PO Box 10363
Russellville, AR 72812
Phone (479) 567-5654
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 |
|---|---|---|---|
| 6576-C | AR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554422400000",
"number": "1790035533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10363",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72812",
"telephone_number": "479-567-5654",
"fax_number": "479-567-5661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 WEST 2ND COURT",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72801",
"telephone_number": "479-567-5654",
"fax_number": "479-567-5661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMBERGER",
"first_name": "MARY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2019-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "6576-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.