Provider Demographics
NPI:1285424374
Name:BAUM, MELINDA JEAN (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:JEAN
Last Name:BAUM
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SCOTLANDS CT
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-7215
Mailing Address - Country:US
Mailing Address - Phone:254-317-0011
Mailing Address - Fax:
Practice Address - Street 1:3205 RANDALL PKWY STE 217
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2569
Practice Address - Country:US
Practice Address - Phone:910-877-1598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0180491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical