Provider Demographics
NPI:1386744936
Name:BAUMANN, WILLIAM R (MSW, LISW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:BAUMANN
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5404 EASTNOL BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-9249
Mailing Address - Country:US
Mailing Address - Phone:937-417-4145
Mailing Address - Fax:
Practice Address - Street 1:227 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1429
Practice Address - Country:US
Practice Address - Phone:937-417-4145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00030861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI-0003086OtherLICENSED INDEPENDENT SW