Provider Demographics
NPI:1063572089
Name:BAUGHMAN, GARY T (LPCC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:T
Last Name:BAUGHMAN
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17747 CHILLICOTHE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4739
Mailing Address - Country:US
Mailing Address - Phone:440-543-8880
Mailing Address - Fax:440-543-5911
Practice Address - Street 1:711 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1039
Practice Address - Country:US
Practice Address - Phone:330-793-2487
Practice Address - Fax:330-793-2487
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003661101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional