Individual
MR. MARK BALDWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
575 S ROYAL ST, SUITE 24, JACKSON, TN 38301-7307
(731) 467-0504
Mailing address
75 HOLIDAY DR, JACKSON, TN 38305-3716
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1878
TN
101YP2500X
Professional Counselor
Primary
1878
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506474
—
TN
Enumeration date
05/07/2007
Last updated
03/03/2015
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