| None | |
|
1012 Ralston Ave Defiance OH 43512-1397 | |
| (419) 591-8093 | |
| Not Available |
| Full Name | None |
|---|---|
| Speciality | Social Worker |
| Location | 1012 Ralston Ave, Defiance, Ohio |
| Authorized Official Name and Position | Susan Marie Lane-baldwin (SOLE PROPRIETOR) |
| Authorized Official Contact | 4195918093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| None Po Box 147 Napoleon OH 43545-0147 Ph: (419) 591-8093 | None 1012 Ralston Ave Defiance OH 43512-1397 Ph: (419) 591-8093 |
| NPI Number | 1700232261 |
|---|---|
| Provider Enumeration Date | 05/13/2016 |
| Last Update Date | 06/28/2016 |
| Medicare PECOS PAC ID | 0042503047 |
|---|---|
| Medicare Enrollment ID | O20160728001613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700232261 | NPI | - | NPPES |
| 0161032 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 00007759-SUPV (Ohio) | Primary |
| Provider Name | Susan Lane-baldwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821245804 PECOS PAC ID: 4385809078 Enrollment ID: I20120702000350 |
Maumee Valley Guidance Center Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 211 Biede Ave, Defiance, OH 43512 Phone: 419-782-8856 Fax: 419-784-4506 | |
Turning Point Psychotherapy And Assessment, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: Turning Point Psychotherapy And Assessment, Llc, 1125 Ralston Ave., Defiance, OH 43512 Phone: 419-782-2800 Fax: 419-782-2805 | |
Defiance Regional Medical Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 Ralston Ave, Defiance, OH 43512 Phone: 419-783-6955 | |
Defiance Regional Psychiatric Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1250 Ralston Ave, Suite 105, Defiance, OH 43512 Phone: 419-783-6805 Fax: 419-783-6804 | |
Defiance Regional Medical Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 Ralston Ave, Defiance, OH 43512 Phone: 419-291-0349 Fax: 419-534-2828 | |
Maumee Valley Guidance Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Biede Ave, Defiance, OH 43512 Phone: 419-782-8856 | |
Cabatan & Associates Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 Clinton St, Defiance, OH 43512 Phone: 419-782-9991 Fax: 419-782-9994 |