Individual provider · NPI-1

Kelly Ann Baumgarden, HSPP

Psychologist, Clinical · Fort Wayne, IN

NPI number1356645873
StatusActive
Last updated in NPPESMar 17, 2018

Details

NPI
1356645873
Entity type
Individual (NPI-1)
Name
Kelly Ann Baumgarden
Credential
HSPP
Sex
Female
Sole proprietor
No
Enumeration date
Dec 23, 2010
Last updated
Mar 17, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, Clinical20043122AINYes

Practice location

2100 Goshen Rd
Fort Wayne, IN 46808-1493

Phone 260-471-3500 · Fax 260-471-4263

Mailing address

2621 E Jefferson St
Warsaw, IN 46580-3880

Phone 574-267-7169

Other practice locations

227 E Main St
Festus, MO 63028-1952

Phone 636-321-0101 · Fax 636-296-6213

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Psychologist, Clinical providers in Fort Wayne, IN