Provider Demographics
NPI:1699977116
Name:BALDWIN, JENNIFER (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC
Mailing Address - Street 1:3 ROMANY PARK LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-4211
Mailing Address - Country:US
Mailing Address - Phone:314-303-5322
Mailing Address - Fax:314-994-3007
Practice Address - Street 1:9378 OLIVE BLVD STE 305
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3256
Practice Address - Country:US
Practice Address - Phone:314-761-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006026670101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO492670005Medicaid