Provider Demographics
NPI:1548276298
Name:BAUMAN, SHERI (LICENSED PSYCHOLOGIS)
Entity type:Individual
Prefix:DR
First Name:SHERI
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MESILLA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-8608
Mailing Address - Country:US
Mailing Address - Phone:505-644-7665
Mailing Address - Fax:505-527-2115
Practice Address - Street 1:330 N CAMPO ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3433
Practice Address - Country:US
Practice Address - Phone:505-644-7665
Practice Address - Fax:505-525-3560
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0776103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMBCBS #00JD77OtherBCBS PROVIDER NUMBER
NM000K7117Medicaid
NMNM102111OtherVALUE OPTIONS