Provider Demographics
NPI:1467884213
Name:BAIRD, SCOTT ALLYN (LCPC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALLYN
Last Name:BAIRD
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-3314
Mailing Address - Country:US
Mailing Address - Phone:309-267-7340
Mailing Address - Fax:
Practice Address - Street 1:503 CARDINAL DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-3314
Practice Address - Country:US
Practice Address - Phone:309-267-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-04
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional