NPI 1497755979 · live from the CMS NPI Registry
Theodore L Baldick, Ph.D.
Psychologist, Clinical in Memphis, TN. National Provider Identifier 1497755979, active.
NPI record
| NPI | 1497755979 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 3950 Central Ave, Memphis, TN 38111 |
| Practice phone | 901-458-6291 |
| Enumerated | July 27, 2005 |
| Last updated | February 4, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist | 103T00000X | 27365 (MS) |
| Psychologist, Addiction (Substance Use Disorder) | 103TA0400X | P0000000685 (TN) |
| Psychologist, Clinical primary | 103TC0700X | P0000000685 (TN) |
| Psychologist, Group Psychotherapy | 103TP2701X | P0000000685 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.