DR. THEODORE L BALDICK (NPI# 1497755979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497755979 |
| Entity Type | Individual |
| Full Name | DR. THEODORE L BALDICK |
| Credential | PH.D. |
| Practice Address |
3950 Central Ave Memphis TN 38111-7602 |
| Practice Telephone | 9014586291 |
| Practice Fax Number | 9013234848 |
| Mailing Telephone | 9014586291 |
| Mailing Fax Number | 9013234848 |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2008-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 27365 | MS | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
P0000000685 | TN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
P0000000685 | TN | Behavioral Health & Social Service Providers |
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
P0000000685 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | TN BLUE SHIELD | 0009713 | 01 |
| TN | CIGNA | 2033550 | 01 |
| Street Address |
3950 CENTRAL AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38111-7602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780179655 | David Stenberg | Counselor | 3950 Central Ave, Memphis, TN 38111 | 2018-06-24 |
| 1811402126 | Marisol Rosas-biser | Counselor | 3950 Central Ave, Memphis, TN 38111-7602 | 2017-12-08 |
| 1235677766 | Jessi R Berger | Counselor | 3950 Central Ave, Memphis, TN 38111-7602 | 2017-02-03 |
| 1528400728 | Janice Lynn Anderson | Counselor | 3950 Central Ave, Memphis, TN 38111-7602 | 2013-07-29 |
| 1356500359 | Marlo Carney Zarzaur | Counselor | 3950 Central Ave, Memphis, TN 38111-7602 | 2008-06-04 |
| 1154460509 | Murff O Galbreath | Social Worker | 3950 Central Ave, Memphis, TN 38111-7602 | 2007-02-05 |
| 1134171135 | Allison M Garrott | Psychologist | 3950 Central Ave, Memphis, TN 38111-7602 | 2006-05-17 |
| 1568425643 | Leila G Todd | Counselor | 3950 Central Ave, Memphis, TN 38111-7602 | 2006-04-10 |
| 1790786762 | Laurie T Haddow | Counselor | 3950 Central Ave, Memphis, TN 38111-7602 | 2005-08-02 |
| 1184625006 | Christian Psychological Center, Inc. | Counselor | 3950 Central Ave, Memphis, TN 38111-7602 | 2005-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982168035 | Meghan Weakley Pace | Occupational Therapist | 177 North Highlanld Ave, Memphis, TN 38111 | 2019-01-23 |
| 1386130466 | Christopher Cory Wilbanks | Nurse Practitioner | 3445 Poplar Ave Ste 18, Memphis, TN 38111 | 2018-07-02 |
| 1124523287 | Hands of Health and Rehab | Clinic/Center | 80 N. Tillman St. Ste. 104, Memphis, TN 38111 | 2018-03-29 |
| 1659889889 | Jarod Lenahan | Specialist/Technologist | 1115 East Getwell Loop St, Memphis, TN 38111 | 2018-01-22 |
| 1831645100 | Bobby Winbush | Residential Treatment Facility, Emotionally Disturbed Children | 1167 Parkland Rd, Memphis, TN 38111 | 2016-08-28 |
| 1356797427 | Shilo Satran | Counselor | 208 Waynoka Lane, Memphis, TN 38111 | 2016-05-09 |
| 1346580552 | Bianca Branch | Psychologist | 4166 W Bufford Ellington Dr, Memphis, TN 38111 | 2013-02-25 |
| 1043563935 | Midsouth Vision Center | Optometrist | 3314 Poplar Ave Ste#1, Memphis, TN 38111 | 2012-10-17 |
| 1235407750 | Demetria Nicole Rogers | Pharmacist | 3515 Park Avenue, Memphis, TN 38111 | 2011-12-12 |
| 1326335647 | Jason Thomas Sasser | Nurse Practitioner | 3444 Plaza Ave., The Little Clinic, Memphis, TN 38111 | 2011-07-07 |
| Find all providers in zip 38111 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447805031 | Jasmine Jones | Psychologist | 516 Tennessee St Ste 225, Memphis, TN 38103-4717 | 2019-08-09 |
| 1649768870 | River City Neuropsychology, Pllc | Psychologist | 1661 International Dr., Suite 400, Memphis, TN 38120 | 2018-04-24 |
| 1265950919 | Memphis Center for Mindful Living, LLC | Psychologist | 4646 Poplar Ave Ste 435, Memphis, TN 38117-4443 | 2017-09-01 |
| 1053869354 | Kimberly Noel Fleming | Psychologist | 512 Alexander St, Memphis, TN 38111-4310 | 2016-09-14 |
| 1003230350 | Kyong Han | Psychologist | 6401 Poplar Ave Ste 420, Memphis, TN 38119-4806 | 2014-02-06 |
| 1578997615 | William Leslie Fulliton | Psychologist | 1407 Union Ave Ste 1407, Memphis, TN 38104 | 2013-08-26 |
| 1073862827 | Joann Paula Raby | Psychologist | 5119 Summer Ave Ste 233, Memphis, TN 38122-4417 | 2012-09-06 |
| 1922236546 | Robert Allen Neimeyer | Psychologist | Department of Psychology 400 Innovation Dr, University of Memphis, Memphis, TN 38152-3230 | 2009-06-23 |
| 1477753564 | Meghan Eileen Mcdevitt-murphy | Psychologist | 202 Psychology Bldg, University of Memphis, Memphis, TN 38152-3230 | 2007-07-18 |
| 1508086976 | Charlotte L Kennedy | Psychologist | 4953 W Old Farm Rd, Memphis, TN 38125-3706 | 2007-04-26 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.