Provider Demographics
NPI:1962710996
Name:BARON, JAMES MICHAEL (MA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:BARON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5571 NORTH GRETNA ROAD
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616
Mailing Address - Country:US
Mailing Address - Phone:417-243-2300
Mailing Address - Fax:417-243-2381
Practice Address - Street 1:5571 NORTH GRETNA ROAD
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616
Practice Address - Country:US
Practice Address - Phone:417-243-2300
Practice Address - Fax:417-243-2381
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60341225400000X
CAMFC52249106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner