Provider Demographics
NPI:1497516744
Name:BAIRD, DOUGLAS CLOWES (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:CLOWES
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 1:2323 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2620
Mailing Address - Country:US
Mailing Address - Phone:502-640-9297
Mailing Address - Fax:
Practice Address - Street 1:2323 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2620
Practice Address - Country:US
Practice Address - Phone:502-640-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY258621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health