Provider Demographics
NPI:1376995886
Name:BAYLY, LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:BAYLY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 FORT SUMNER DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2464
Mailing Address - Country:US
Mailing Address - Phone:301-461-7419
Mailing Address - Fax:
Practice Address - Street 1:4809 FORT SUMNER DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2464
Practice Address - Country:US
Practice Address - Phone:301-461-7419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0889621041C0700X
CT116211041C0700X
VA09040132791041C0700X
DC2000025391041C0700X
MD278271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical