Provider Demographics
NPI:1528335197
Name:BALDWIN, DAVID MARLIN (LPC, LCDC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MARLIN
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 BOBWHITE DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-2243
Mailing Address - Country:US
Mailing Address - Phone:432-813-4031
Mailing Address - Fax:
Practice Address - Street 1:3300 S FM 1788
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706-2601
Practice Address - Country:US
Practice Address - Phone:432-813-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66353101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor