Provider Demographics
NPI:1275899775
Name:BAIRD, JESSICA ESTHER (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ESTHER
Last Name:BAIRD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3033
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98046-3033
Mailing Address - Country:US
Mailing Address - Phone:206-902-7485
Mailing Address - Fax:
Practice Address - Street 1:17320 76TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-5007
Practice Address - Country:US
Practice Address - Phone:206-902-7485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60219752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health