NPI 1295906576 · live from the CMS NPI Registry
Kim Marie Baldwin, PsyD
Psychologist, Clinical in Bloomington, IL. National Provider Identifier 1295906576, active.
NPI record
| NPI | 1295906576 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 207 W Jefferson St Ste 304, Bloomington, IL 61701 |
| Practice phone | 309-204-6614 |
| Enumerated | March 14, 2008 |
| Last updated | September 14, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166000794 (IL) |
| Psychologist, Clinical primary | 103TC0700X | 071008516 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.