Provider Demographics
NPI:1154729200
Name:BAUM, CHRIS LYNN (LIMHP)
Entity type:Individual
Prefix:MS
First Name:CHRIS
Middle Name:LYNN
Last Name:BAUM
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:LYNN
Other - Last Name:BAUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LIMHP
Mailing Address - Street 1:2430 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1655
Mailing Address - Country:US
Mailing Address - Phone:308-672-5432
Mailing Address - Fax:
Practice Address - Street 1:4021 AVENUE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4602
Practice Address - Country:US
Practice Address - Phone:308-630-1500
Practice Address - Fax:308-630-1516
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health