Provider Demographics
NPI:1104136951
Name:BAUGH, KAREN NICOLETTI (LMHC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:NICOLETTI
Last Name:BAUGH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2635 SW 35TH PL
Mailing Address - Street 2:APT. 803
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3294
Mailing Address - Country:US
Mailing Address - Phone:352-244-0628
Mailing Address - Fax:352-244-0668
Practice Address - Street 1:3615 SW 13TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-3517
Practice Address - Country:US
Practice Address - Phone:352-244-0628
Practice Address - Fax:352-244-0668
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4848101YM0800X, 101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL761854900Medicaid