Provider Demographics
NPI:1609224773
Name:BAYLES, LESLIE ELAINE (LCADC)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ELAINE
Last Name:BAYLES
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 EAST AVE
Mailing Address - Street 2:UNIT 9
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2662
Mailing Address - Country:US
Mailing Address - Phone:908-441-1563
Mailing Address - Fax:908-850-6864
Practice Address - Street 1:112 EAST AVE
Practice Address - Street 2:UNIT 9
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2662
Practice Address - Country:US
Practice Address - Phone:908-441-1563
Practice Address - Fax:908-850-6864
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00096200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)