Thomas Baughman, L.I.S.A.C.
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Fort Mohave, AZ
NPI 1992977300 · NPPES record last updated Mar 25, 2008
Key facts
- NPI
- 1992977300
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- LISAC 10256 (AZ)
- Practice address
- 5767 Ruth Dr
Fort Mohave, AZ 86426-8828 - Phone
- (928) 768-3506
- NPI assigned
- Mar 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| LISAC 10256 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LISAC 10256 | AZ | Yes |
Addresses
Primary practice location
5767 Ruth Dr
Fort Mohave, AZ 86426-8828
Mailing address
5767 Ruth Dr
Fort Mohave, AZ 86426-8828
Phone (928) 768-3506
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LISAC 10256 | Other | AZ | AZBBHE |
Other providers in Fort Mohave, AZ
- Rose Marie Bard-Jensen
- Kayla Barnett
- Alan Joseph Barton
- Hylie Elaine Barton
- Mervat Basta
- Richard P Benedict
- Nathan Eric Beneze
- Donna Bennett
- Dayna Blake
- Blue River Health & Wellness, PLLC
All providers in Fort Mohave, AZ · Addiction (Substance Use Disorder) Counselor in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2008. 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.