Provider Demographics
NPI:1932908142
Name:BAUMAN, ROBIN PONCE (LCPC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:PONCE
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 N 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3112
Mailing Address - Country:US
Mailing Address - Phone:406-624-9748
Mailing Address - Fax:
Practice Address - Street 1:1800 W KOCH ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-1301
Practice Address - Country:US
Practice Address - Phone:406-624-9748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT78894101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional