Provider Demographics
NPI:1528598398
Name:BAYMON, BRITTANY ANDREA (LCSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANDREA
Last Name:BAYMON
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 1:1615 DRASCO DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-2660
Mailing Address - Country:US
Mailing Address - Phone:773-306-8819
Mailing Address - Fax:
Practice Address - Street 1:1615 DRASCO DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-2660
Practice Address - Country:US
Practice Address - Phone:773-306-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX679731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health