Provider Demographics
NPI:1730454893
Name:BALDWIN, ELEANOR C (MSW)
Entity type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:C
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:KESWICK
Mailing Address - State:VA
Mailing Address - Zip Code:22947-2614
Mailing Address - Country:US
Mailing Address - Phone:434-923-8679
Mailing Address - Fax:
Practice Address - Street 1:844 CLUB DR
Practice Address - Street 2:
Practice Address - City:KESWICK
Practice Address - State:VA
Practice Address - Zip Code:22947-2614
Practice Address - Country:US
Practice Address - Phone:434-923-8670
Practice Address - Fax:434-923-8679
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040049751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical