Provider Demographics
NPI:1164701512
Name:BAIRD, RICHARD SANDERS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:SANDERS
Last Name:BAIRD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 WEST ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6361
Mailing Address - Country:US
Mailing Address - Phone:203-791-5121
Mailing Address - Fax:203-830-6088
Practice Address - Street 1:152 WEST ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6361
Practice Address - Country:US
Practice Address - Phone:203-791-5121
Practice Address - Fax:203-830-6088
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0009871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical