Provider Demographics
NPI:1164238838
Name:BALDWIN, SHAUNTARA (MSW)
Entity type:Individual
Prefix:
First Name:SHAUNTARA
Middle Name:
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 1:3159 CARPENTERS PARK RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15928-9223
Mailing Address - Country:US
Mailing Address - Phone:814-408-0014
Mailing Address - Fax:814-479-5906
Practice Address - Street 1:1925 NE STUCKI AVE STE 150
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006-6950
Practice Address - Country:US
Practice Address - Phone:814-408-0014
Practice Address - Fax:814-479-5906
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical