Provider Demographics
NPI:1427806058
Name:BAUMBACH, NICKI (LCSW, MPH)
Entity type:Individual
Prefix:
First Name:NICKI
Middle Name:
Last Name:BAUMBACH
Suffix:
Gender:F
Credentials:LCSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 30TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1258
Mailing Address - Country:US
Mailing Address - Phone:303-910-0031
Mailing Address - Fax:
Practice Address - Street 1:2500 30TH ST STE 206
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1258
Practice Address - Country:US
Practice Address - Phone:303-910-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099304221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical