Provider Demographics
NPI:1336893007
Name:BAUGH, CHLOE ISABELLE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:ISABELLE
Last Name:BAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1538
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-0115
Mailing Address - Country:US
Mailing Address - Phone:541-574-9570
Mailing Address - Fax:541-574-8857
Practice Address - Street 1:607 SW HURBERT ST STE 103
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4998
Practice Address - Country:US
Practice Address - Phone:541-270-4717
Practice Address - Fax:541-272-5112
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21-10-10255101YA0400X
OR20-CRM-267175T00000X
ORA15457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist