Provider Demographics
NPI:1699188995
Name:BAWAYA, INA TOWNLEY (LCSW, MFA)
Entity Type:Individual
Prefix:MS
First Name:INA
Middle Name:TOWNLEY
Last Name:BAWAYA
Suffix:
Gender:F
Credentials:LCSW, MFA
Other - Prefix:
Other - First Name:INA
Other - Middle Name:LEE
Other - Last Name:TOWNLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12820 THOMTE RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-6808
Mailing Address - Country:US
Mailing Address - Phone:505-293-2768
Mailing Address - Fax:
Practice Address - Street 1:3901 GEORGIA ST NE
Practice Address - Street 2:STE A4
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1391
Practice Address - Country:US
Practice Address - Phone:505-803-7150
Practice Address - Fax:505-293-0617
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-085841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical