Provider Demographics
NPI:1427180579
Name:BAYNE, HAROLD STANLEY (MALPC CERTIFED CLINI)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:STANLEY
Last Name:BAYNE
Suffix:
Gender:M
Credentials:MALPC CERTIFED CLINI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HEALING FARM LANE
Mailing Address - Street 2:
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756
Mailing Address - Country:US
Mailing Address - Phone:828-894-7122
Mailing Address - Fax:828-894-7111
Practice Address - Street 1:101 HEALING FARM LANE
Practice Address - Street 2:
Practice Address - City:MILL SPRING
Practice Address - State:NC
Practice Address - Zip Code:28756
Practice Address - Country:US
Practice Address - Phone:828-894-7122
Practice Address - Fax:828-894-7111
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC905101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102994Medicaid