Provider Demographics
NPI:1194078402
Name:BAUMAN, CHRISTY VIDRINE (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:VIDRINE
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 1ST AVE W
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-4298
Mailing Address - Country:US
Mailing Address - Phone:407-595-7999
Mailing Address - Fax:
Practice Address - Street 1:200 1ST AVE W
Practice Address - Street 2:SUITE 400
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-4298
Practice Address - Country:US
Practice Address - Phone:407-595-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60197828101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health